Organization
JUBILEE PEDIATRIC SPEECH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI G FORAN PH.D., CCC-SLP (OWNER)
(251) 340-2166
Entity
Organization
Contact information
Practice address
9086 MERRITT LN, SUITE D, DAPHNE, AL 36526-5612
(251) 340-2166
(251) 405-3416
Mailing address
9086 MERRITT LN, SUITE D, DAPHNE, AL 36526-5612
(251) 340-2166
(251) 405-3416
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2955
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518101047
—
GA
Enumeration date
12/14/2015
Last updated
06/21/2016
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