Organization
ATLANTIC SPEECH THERAPY
Active
Parent organization
ATLANTIC SPEECH THERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATLANTIC SPEECH THERAPY
Authorized official
MRS. JESSICA BETH OTTO MS. CCC-SLP (OWNER/DIRECTOR)
(904) 652-5408
Entity
Organization
Contact information
Practice address
145 HILDEN ROAD #113, PONTE VEDRA, FL 32081-5139
(904) 652-5408
(877) 652-5052
Mailing address
11512 LAKE MEAD AVE, SUITE 604, JACKSONVILLE, FL 32256-9680
(904) 652-5408
(877) 652-5052
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 11834
FL
Other
Enumeration date
12/05/2016
Last updated
03/22/2019
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