Organization
A PLACE TO GROW PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE MAHONEY CCC-SLP (OWNER/SPEECH-LANGUAGE PATHOLOGIST)
(352) 359-1725
Entity
Organization
Contact information
Practice address
64 ROLLINS LN, PALM COAST, FL 32164-6947
(352) 359-1725
Mailing address
64 ROLLINS LN, PALM COAST, FL 32164-6947
(352) 359-1725
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA11599
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002828400
—
FL
Enumeration date
06/23/2017
Last updated
07/21/2022
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