Provider Demographics
NPI:1508229865
Name:TRILANGUE SPEECH THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:TRILANGUE SPEECH THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAMILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPARD-WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:SLP, MS, CCC
Authorized Official - Phone:305-968-5007
Mailing Address - Street 1:4748 SW 39TH WAY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4748 SW 39TH WAY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5446
Practice Address - Country:US
Practice Address - Phone:305-968-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-03
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892045100Medicaid