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
-
Aimee Mahoney, M.S, CCC-SLP
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002828400 | Medicaid | FL |
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All providers in Palm Coast, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.