Organization · NPI-2

A Place To Grow Pediatric Therapy

Speech-Language Pathologist, · Palm Coast, FL

NPI number1972023620
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1972023620
Entity type
Organization (NPI-2)
Legal business name
A Place To Grow Pediatric Therapy
Organization subpart
No
Enumeration date
Jun 23, 2017
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,SA11599FLYes

Practice location

64 Rollins Ln
Palm Coast, FL 32164-6947

Phone 352-359-1725

Mailing address

64 Rollins Ln
Palm Coast, FL 32164-6947

Phone 352-359-1725

Authorized official

Aimee Mahoney
Owner/Speech-Language Pathologist
3523591725

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