Provider Demographics
NPI:1083747646
Name:CENTER FOR SPEECH AND LANGUAGE, T.C,, INC.
Entity Type:Organization
Organization Name:CENTER FOR SPEECH AND LANGUAGE, T.C,, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:SMEDS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:772-334-1227
Mailing Address - Street 1:940 NE JENSEN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4704
Mailing Address - Country:US
Mailing Address - Phone:772-334-1227
Mailing Address - Fax:772-334-0225
Practice Address - Street 1:940 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4704
Practice Address - Country:US
Practice Address - Phone:772-334-1227
Practice Address - Fax:772-334-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 0000900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty