Organization
SPEECH AVENUES THERAPY CO
Active
Other names
Speech Pathways of Brevard Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAIL WALTER M.S.CCC-SLP (CEO)
(321) 338-2419
Entity
Organization
Contact information
Practice address
107 LONGWOOD AVE, ROCKLEDGE, FL 32955-2827
(321) 338-2419
(321) 301-4278
Mailing address
4555 SHOWDOW ST, COCOA, FL 32926-2807
(321) 338-2419
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
SA12232
FL
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006382800
—
FL
Enumeration date
09/20/2017
Last updated
07/20/2022
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