Provider Demographics
NPI:1821804329
Name:ENCORE SPEECH & WELLNESS, LLC
Entity type:Organization
Organization Name:ENCORE SPEECH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAIJA
Authorized Official - Middle Name:CULTER
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:321-292-2268
Mailing Address - Street 1:132 RAINBOW ST
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-6241
Mailing Address - Country:US
Mailing Address - Phone:909-289-3406
Mailing Address - Fax:
Practice Address - Street 1:400 FORTENBERRY RD STE B
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3522
Practice Address - Country:US
Practice Address - Phone:321-292-2268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty