Organization
ATLANTIC SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA OTTO (DIRECTOR/OWNER)
(904) 652-5408
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 652-5408
Mailing address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
15996
FL
Other
Enumeration date
10/08/2013
Last updated
10/08/2013
About Stedi
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