Organization
BAYSIDE SPEECH THERAPY, INC.
Active
Other names
Bayside Therapy Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE M YATES MS CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(813) 944-9594
Entity
Organization
Contact information
Practice address
5647 GULF DR, NEW PORT RICHEY, FL 34652-4019
(813) 435-3355
Mailing address
5647 GULF DR, NEW PORT RICHEY, FL 34652-4019
(813) 435-3355
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014254700
—
FL
Enumeration date
02/07/2015
Last updated
08/02/2024
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