Provider Demographics
NPI:1073130621
Name:FREEDOM OF SPEECH THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:FREEDOM OF SPEECH THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ROHRBORN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:805-843-5941
Mailing Address - Street 1:1500 N UNIVERSITY DR STE 233
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8971
Mailing Address - Country:US
Mailing Address - Phone:954-372-4040
Mailing Address - Fax:
Practice Address - Street 1:1500 N UNIVERSITY DR STE 233
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8971
Practice Address - Country:US
Practice Address - Phone:954-372-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107129400Medicaid
FL108445500Medicaid