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Organization

BEACHSIDE SPEECH CLUB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARISSA O'NEIL M.S., CCC-SLP (SPEECH LANGUAGE PATHOLOGIST/OWNER)
(386) 457-9532
Entity
Organization

Contact information

Practice address
114 DIXWOOD AVE, EDGEWATER, FL 32132-1604
(386) 320-6130
Mailing address
114 DIXWOOD AVE, EDGEWATER, FL 32132-1604

Taxonomy

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

Other

Enumeration date
01/24/2023
Last updated
01/24/2023
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