Individual
BEULAH ISRAEL WYNN DBA SPEECH EFX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6322 25TH ST S, APT 142, SAINT PETERSBURG, FL 33712-5399
(727) 866-7603
Mailing address
6322 25TH ST S, APT 142, SAINT PETERSBURG, FL 33712-5399
(727) 866-7603
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA6658
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12046539
ASHA SLP LICENSE
FL
05
—
887698300
—
FL
01
—
SA6658
DOH SLP LICENSE
FL
Enumeration date
04/19/2007
Last updated
07/09/2007
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