Provider Demographics
NPI:1629359450
Name:OF SPECIAL NOTE INC.
Entity Type:Organization
Organization Name:OF SPECIAL NOTE INC.
Other - Org Name:FLORIDA CENTER FOR PROFESSIONAL VOICE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, FL CTR FOR PROF. VOICE
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WICKLUND
Authorized Official - Suffix:
Authorized Official - Credentials:DM, MHS CCC-SLP
Authorized Official - Phone:847-476-7464
Mailing Address - Street 1:8374 MARKET ST
Mailing Address - Street 2:BOX 523
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5137
Mailing Address - Country:US
Mailing Address - Phone:847-476-7464
Mailing Address - Fax:
Practice Address - Street 1:12918 NIGHTSHADE PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-2818
Practice Address - Country:US
Practice Address - Phone:847-476-7464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty