Provider Demographics
NPI:1033522552
Name:PHONETICALLY SPEAKING, INC
Entity Type:Organization
Organization Name:PHONETICALLY SPEAKING, INC
Other - Org Name:THE THERAPY CLOSET FL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:904-710-8913
Mailing Address - Street 1:450 STATE ROAD 13 STE 106
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-3863
Mailing Address - Country:US
Mailing Address - Phone:904-329-6458
Mailing Address - Fax:904-677-7800
Practice Address - Street 1:1008 BUTTERCUP DR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-4510
Practice Address - Country:US
Practice Address - Phone:904-710-8913
Practice Address - Fax:904-677-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010679000Medicaid