Provider Demographics
NPI:1891496063
Name:MIND TO MOUTH SPEECH & LANGUAGE THERAPY SERVICES
Entity Type:Organization
Organization Name:MIND TO MOUTH SPEECH & LANGUAGE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMPE
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:813-716-7181
Mailing Address - Street 1:11613 BLUE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2746
Mailing Address - Country:US
Mailing Address - Phone:813-716-7181
Mailing Address - Fax:
Practice Address - Street 1:11613 BLUE WOODS DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2746
Practice Address - Country:US
Practice Address - Phone:813-716-7181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech