Your Speech Therapist, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA2045 Issued in FL

Legal business name

YOUR SPEECH THERAPIST, INC.

Practice address

8178 Sandpiper Glen Drive
Lake Worth, FL 33467-6946

Phone

(954) 778-8867

NPI assigned

Dec 8, 2011

Organization subpart

No

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

Authorized official

Name

Marc H Mitnick, MS/CCC-SLP

Title

Pres

Phone

(954) 778-8876

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1710255492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8178 SANDPIPER GLEN DRIVE",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676946",
            "telephone_number": "954-778-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8178 SANDPIPER GLEN DRIVE",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676946",
            "telephone_number": "954-778-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR SPEECH THERAPIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "MITNICK",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "954-778-8876",
        "authorized_official_credential": "MS/CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA2045",
            "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 Jun 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.