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Organization

PONTE VEDRA SPEECH LANGUAGE AND LEARNING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SONYA MARIE OLSEN MS, CCC-SLP (CEO)
(904) 844-3136
Entity
Organization

Contact information

Practice address
30 TAVERNIER DR STE B, PONTE VEDRA, FL 32081-1270
(904) 404-2345
(904) 789-6295
Mailing address
30 TAVERNIER DR STE B, PONTE VEDRA, FL 32081-1270
(904) 404-2345
(904) 789-6295

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
124351900
FL
01
SA19092
FLORIDA BOARD OF SPEECH-LANGAUGE PATHOLOGY AND AUDIOLOGY SONYA OLSEN
FL
01
SA22939
FLORIDA BOARD OF SPEECH-LANGAUGE PATHOLOGY AND AUTUMN WOOD
FL
Enumeration date
07/14/2023
Last updated
02/24/2026
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