Organization
HOLISTIC SPEECH THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MCKENZIE (OWNER)
(904) 463-2510
Entity
Organization
Contact information
Practice address
1013 ENON CT, ST AUGUSTINE, FL 32092-0431
(904) 463-2510
(904) 940-4795
Mailing address
1013 ENON CT, ST AUGUSTINE, FL 32092-0431
(904) 463-2510
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA9049
FL
Other
Enumeration date
11/09/2009
Last updated
01/11/2010
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