Individual
MRS. ALICIA B MANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
662 SE 47TH LOOP, OCALA, FL 34480-4774
(352) 572-0187
Mailing address
662 SE 47TH LOOP, OCALA, FL 34480-4774
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6643
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
229580
HEALTHEASE GRP
FL
01
—
S2409
BCBS OF FLORIDA
FL
Enumeration date
01/23/2007
Last updated
07/09/2007
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