Organization
DISTRICT SPEECH AND SWALLOW REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKI DIANE SHIBATA MS, CCC-SLP (OWNER)
(904) 441-0302
Entity
Organization
Contact information
Practice address
200 Q ST NE APT 2237, WASHINGTON, DC 20002-2390
(904) 441-0302
(202) 217-2104
Mailing address
200 Q ST NE APT 2237, WASHINGTON, DC 20002-2390
(904) 441-0302
(202) 217-2104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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