A Place to Grow Pediatric Therapy

Organization Active NPI Speech-Language Pathologist · Palm Coast, FL

NPI 1972023620 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1972023620
Entity type
Organization (NPI type 2)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SA11599 (FL)
Legal business name
A PLACE TO GROW PEDIATRIC THERAPY
Practice address
64 Rollins LN
Palm Coast, FL 32164-6947
Phone
(352) 359-1725
NPI assigned
Jun 23, 2017
Organization subpart
No

Authorized official

Name
Aimee Mahoney, CCC-SLP
Title
Owner/Speech-Language Pathologist
Phone
(352) 359-1725

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X SA11599 FL Yes

Addresses

Primary practice location

64 Rollins LN
Palm Coast, FL 32164-6947

Mailing address

64 Rollins LN
Palm Coast, FL 32164-6947
Phone (352) 359-1725

Other identifiers

IdentifierTypeStateIssuer
002828400MedicaidFL

Other providers in Palm Coast, FL

All providers in Palm Coast, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.