Speech and Language Associates

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA112 Issued in FL

Legal business name

SPEECH AND LANGUAGE ASSOCIATES

Practice address

4631 NW 53Rd Ave
Suite 104
Gainesville, FL 32653-3402

Phone

(352) 373-5389

Fax

(352) 335-0517

NPI assigned

Jan 4, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary Patricia Stephan, M.S., CCC/SLP

Title

Owner/Director

Phone

(352) 373-5389

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1194095315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 NW 53RD AVE",
            "address_2": "SUITE 104",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326533402",
            "telephone_number": "352-373-5389",
            "fax_number": "352-335-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 NW 53RD AVE",
            "address_2": "SUITE 104",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326533402",
            "telephone_number": "352-373-5389",
            "fax_number": "352-335-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH AND LANGUAGE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "STEPHAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "352-373-5389",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.