Individual
ENRI FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
1992 LEWIS TURNER BLVD SUITE 1067 #255, FORT WALTON BEEACH, FL 32547
(850) 830-3314
(850) 904-0355
Mailing address
106 BLACK BEAR CIR, NICEVILLE, FL 32578-1202
(850) 830-3314
(850) 904-0355
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
18378
FL
235Z00000X
Speech-Language Pathologist
Primary
SA18378
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117493600
—
FL
05
—
117725200
—
FL
05
—
118480700
—
FL
05
—
118599100
—
FL
01
—
12030298
ASHA CCC
MD
01
—
SA18378
DOH
FL
Enumeration date
01/16/2020
Last updated
11/10/2024
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