Organization
EXCEPTIONAL SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER OSORIO (DIRECTOR/SPEECH LANGUAGE PATHOLOGIS)
(305) 733-3405
Entity
Organization
Contact information
Practice address
10200 NW 25TH ST STE A-108, DORAL, FL 33172-5921
(786) 717-5649
Mailing address
10200 NW 25TH ST STE A-108, DORAL, FL 33172-5921
(786) 717-5649
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT15005
FL
235Z00000X
Speech-Language Pathologist
SA11047
FL
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002675000
—
FL
Enumeration date
08/02/2013
Last updated
07/21/2022
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