Organization
GENESIS REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN GAYLE MARDJETKO MSCCCSLP (SPEECH LANGUAGE PATHOLOGIST)
(727) 378-8586
Entity
Organization
Contact information
Practice address
7927 STATE ROAD 52, HUDSON, FL 34667-6783
(727) 378-8586
(727) 378-8587
Mailing address
7927 STATE ROAD 52, HUDSON, FL 34667-6783
(727) 378-8586
(727) 378-8587
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA2502
FL
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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