Organization
ATLANTIC SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA OTTO (OWNER/DIRECTOR)
(904) 652-5408
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE., SUITE 604, JACKSONVILLE, FL 32256
(904) 652-5408
(877) 652-5052
Mailing address
11512 LAKE MEAD AVE., SUITE 604, JACKSONVILLE, FL 32256
(904) 652-5408
(877) 652-5052
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA5968
FL
235Z00000X
Speech-Language Pathologist
SA9598
FL
Other
Enumeration date
10/21/2008
Last updated
03/23/2015
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