Provider Demographics
NPI:1629303219
Name:THE APHASIA CENTER
Entity Type:Organization
Organization Name:THE APHASIA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARTELS-TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-823-2529
Mailing Address - Street 1:6830 CENTRAL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1208
Mailing Address - Country:US
Mailing Address - Phone:727-823-2529
Mailing Address - Fax:727-289-7062
Practice Address - Street 1:6830 CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1208
Practice Address - Country:US
Practice Address - Phone:727-823-2529
Practice Address - Fax:727-289-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty