Organization
CLEMENTINE SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AEMELIA LYNN JACKSON (CEO)
(757) 636-0746
Entity
Organization
Contact information
Practice address
1911 BURLINGTON AVE N, ST PETERSBURG, FL 33713-8030
(757) 636-0746
Mailing address
1911 BURLINGTON AVE N, ST PETERSBURG, FL 33713-8030
(757) 636-0746
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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