Provider Demographics
NPI:1225440340
Name:WORDS OF WONDER SPEECH-LANGUAGE PATHOLOGY SERVCES, LLC.
Entity Type:Organization
Organization Name:WORDS OF WONDER SPEECH-LANGUAGE PATHOLOGY SERVCES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:QADRI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:352-817-4765
Mailing Address - Street 1:2042 MICHAEL TIAGO CIR
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-8669
Mailing Address - Country:US
Mailing Address - Phone:352-817-4765
Mailing Address - Fax:
Practice Address - Street 1:1365 LAKE BALDWIN LN
Practice Address - Street 2:APT. 203
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6751
Practice Address - Country:US
Practice Address - Phone:407-443-1962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9030235Z00000X
FLSA8897235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty