Organization
EASTERSEALS NORTHEAST CENTRAL FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY JOHNSON (CHIEF EXECUTIVE OFFICER)
(386) 255-4568
Entity
Organization
Contact information
Practice address
1219 DUNN AVE, DAYTONA BEACH, FL 32114
(386) 255-4568
(386) 252-3403
Mailing address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
(386) 252-3403
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
FL
Other
Enumeration date
02/20/2007
Last updated
05/29/2018
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