Provider Demographics
NPI:1790420198
Name:EMPOWERED VOICE REHABILITATION LLC
Entity type:Organization
Organization Name:EMPOWERED VOICE REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VOICE & SWALLOWING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAELIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:904-539-9930
Mailing Address - Street 1:10950-60 SAN JOSE BLVD
Mailing Address - Street 2:#268
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223
Mailing Address - Country:US
Mailing Address - Phone:904-539-9939
Mailing Address - Fax:904-395-2255
Practice Address - Street 1:15754 SPOTTED SADDLE CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7979
Practice Address - Country:US
Practice Address - Phone:904-539-9939
Practice Address - Fax:904-395-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech