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Individual

MR. MATTHEW OMALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SLPA, ITDS

Contact information

Practice address
201 THORNBERRY BRANCH LN, DAYTONA BEACH, FL 32124-3652
(317) 340-9490
Mailing address
600 DOMENICO CIR UNIT C14, ST AUGUSTINE, FL 32086-7813
(317) 340-9490

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI3849
FL
252Y00000X
Early Intervention Provider Agency

Other

Enumeration date
05/07/2019
Last updated
05/07/2019
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