Organization
KID PRO THERAPY - BOAS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINNE JONES M.A., CCC-SLP, PH.D. (DIRECTOR)
(813) 964-8481
Entity
Organization
Contact information
Practice address
16546 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 964-8481
(813) 964-8431
Mailing address
16546 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 964-8481
(813) 964-8431
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
SA7752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889948700
—
FL
Enumeration date
03/05/2007
Last updated
08/12/2008
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