Organization
FOUNDATIONS: SPEECH, LANGUAGE AND LEARNING SERVICES
Active
Organization
FOUNDATIONS: SPEECH, LANGUAGE AND LEARNING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA C CLARK M.S., CCC-SLP (OWNER/ SPEECH LANGUAGE PATHOLOGIST)
(904) 397-0004
Entity
Organization
Contact information
Practice address
11787 BLUEBERRY LN, MACCLENNY, FL 32063-4163
(904) 397-0004
Mailing address
11787 BLUEBERRY LN, MACCLENNY, FL 32063-4163
(904) 397-0004
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SA5772
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001229500
—
FL
05
—
001229700
—
FL
01
—
1811123060
INDIVIDUAL NPI NUMBER
FL
Enumeration date
12/05/2009
Last updated
12/05/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up