Organization
ADVANCE SPEECH AND LANGUAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGIE FAY ADDISON MS, CCC-SLP (OWNER)
(850) 843-1052
Entity
Organization
Contact information
Practice address
214 NORTH WASHINGTON STREET, PERRY, FL 32347
(850) 843-1052
Mailing address
629 SW MORRIS STEEN ROAD, GREENVILLE, FL 32331
(850) 843-1052
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA8913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892105900
—
FL
Enumeration date
05/03/2007
Last updated
06/17/2008
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