Individual
ERICA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Mailing address
3308 SAN MOISE PL, PLANT CITY, FL 33567-1719
(863) 337-9507
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SI2201
FL
235Z00000X
Speech-Language Pathologist
Primary
SZ6442
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009862500
—
FL
Enumeration date
08/14/2013
Last updated
03/09/2023
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