Organization
EMILY DYKSTRA MA, CCC-SLP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY ELLEN DYKSTRA MA, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(407) 928-5378
Entity
Organization
Contact information
Practice address
1146 WOODLAND TERRACE TRL, ALTAMONTE SPRINGS, FL 32714-1805
(407) 928-5378
(407) 522-8293
Mailing address
1146 WOODLAND TERRACE TRL, ALTAMONTE SPRINGS, FL 32714-1805
(407) 928-5378
(407) 522-8293
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890146500
—
FL
Enumeration date
05/29/2012
Last updated
05/29/2012
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