Individual
ANIA SEOANE THIERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6913 COHASSET CIR, RIVERVIEW, FL 33578-8314
(813) 928-3312
Mailing address
4504 KENNEWICK PL, RIVERVIEW, FL 33569-2122
(813) 928-3312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA8303
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890398100
—
FL
01
—
S9174
BCBS
FL
01
—
SA 8308
SPEECH LANGUAGE PATHOLOGI
FL
Enumeration date
06/22/2006
Last updated
01/11/2019
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