Individual
ANNA JANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12030 SW 129TH CT STE 209, MIAMI, FL 33186-4584
(786) 429-3619
Mailing address
3601 SW 117TH AVE APT 405, MIAMI, FL 33175-1765
(305) 793-9783
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA16488
FL
Other
Enumeration date
08/17/2017
Last updated
08/14/2019
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