Individual
MRS. ALLA FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
14 WOODFORD LN, PALM COAST, FL 32164-7927
(917) 579-2964
Mailing address
14 WOODFORD LN, PALM COAST, FL 32164-7927
(917) 579-2964
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7988
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892483000
—
FL
Enumeration date
01/15/2008
Last updated
04/16/2019
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