Individual
BEVERLY KOOGLE MONDLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
241 BRASSWOOD CT, DAYTONA BEACH, FL 32117-7127
(410) 913-8479
Mailing address
241 BRASSWOOD CT, DAYTONA BEACH, FL 32117-7127
(410) 913-8479
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA13340
FL
Other
Enumeration date
03/07/2017
Last updated
04/26/2026
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