Organization
INNOVATIVE SPEECH THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIET WILLIAMS (PRESIDENT)
(754) 234-6577
Entity
Organization
Contact information
Practice address
1597 SW 194TH TER, PEMBROKE PINES, FL 33029-6161
(754) 234-6577
Mailing address
1597 SW 194TH TER, PEMBROKE PINES, FL 33029-6161
(754) 234-6577
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
SA 9460
FL
235Z00000X
Speech-Language Pathologist
Primary
SA 9460
FL
Other
Enumeration date
12/28/2009
Last updated
08/01/2012
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