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Organization

FORGOTTEN COAST SPEECH, LANGUAGE, AND SWALLOWING REHAB LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VALERIE DAWN MASON M.S., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST/OWNER)
(352) 538-6177
Entity
Organization

Contact information

Practice address
42 EVENING STAR DR, CRAWFORDVILLE, FL 32327-0686
(352) 538-6177
Mailing address
42 EVENING STAR DR, CRAWFORDVILLE, FL 32327-0686
(352) 538-6177

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015670500
FL
Enumeration date
09/13/2019
Last updated
09/29/2020
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