Organization
GC THERAPY OPTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIS MARIE STEPHENS MA CCC-SLP (MEMBER)
(386) 365-7889
Entity
Organization
Contact information
Practice address
405 11TH ST SW, LIVE OAK, FL 32064-3161
(386) 365-7889
Mailing address
400 OHIO AVE S UNIT 177, LIVE OAK, FL 32064-7707
(386) 365-7889
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 4901
FL
235Z00000X
Speech-Language Pathologist
SA 7684
FL
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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