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Organization

AXOLOTL SPEECH THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIZIANA PEREIRA M.S.,CCC-SLP (PRESIDENT)
(954) 663-4530
Entity
Organization

Contact information

Practice address
4703 GRAPEVINE WAY, DAVIE, FL 33331-3359
(954) 663-4530
Mailing address
4703 GRAPEVINE WAY, DAVIE, FL 33331-3359
(954) 663-4530

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
01/16/2025
Last updated
01/16/2025
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