Organization
IMARI'S THERAPY SERVICES P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEQUESTA D THOMAS-ALLEN M.S. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(813) 205-0969
Entity
Organization
Contact information
Practice address
5230 E FOWLER AVE, TEMPLE TERRACE, FL 33617-2147
(813) 374-9414
Mailing address
5230 E FOWLER AVE, TEMPLE TERRACE, FL 33617-2147
(813) 374-9414
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010239000
—
FL
Enumeration date
12/04/2013
Last updated
07/21/2014
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