Provider Demographics
NPI:1164046025
Name:HELLO SUNSHINE SPEECH AND LANGUAGE THERAPY, INC.
Entity Type:Organization
Organization Name:HELLO SUNSHINE SPEECH AND LANGUAGE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:561-602-5844
Mailing Address - Street 1:631 LUCERNE AVE STE 54
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3820
Mailing Address - Country:US
Mailing Address - Phone:561-464-2101
Mailing Address - Fax:
Practice Address - Street 1:631 LUCERNE AVE STE 54
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33460-3820
Practice Address - Country:US
Practice Address - Phone:561-464-2101
Practice Address - Fax:561-331-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1851700579Medicaid