Organization
FULL SPECTRUM SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARROLL STREETMAN (GENERAL MANAGER)
(813) 926-5454
Entity
Organization
Contact information
Practice address
16414 LAKE CHURCH DR, ODESSA, FL 33556-2637
(813) 926-5454
Mailing address
16414 LAKE CHURCH DR, ODESSA, FL 33556-2637
(813) 926-5454
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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