Provider Demographics
NPI:1831166222
Name:CHARLOTTE M HARVEY SPEECH PATHOLOGIST PA
Entity type:Organization
Organization Name:CHARLOTTE M HARVEY SPEECH PATHOLOGIST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD CCC SLP
Authorized Official - Phone:407-830-8892
Mailing Address - Street 1:PO BOX 521358
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32752-1358
Mailing Address - Country:US
Mailing Address - Phone:407-830-8892
Mailing Address - Fax:407-834-0769
Practice Address - Street 1:22 W LAKE BEAUTY DR
Practice Address - Street 2:STE 304
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:321-436-7638
Practice Address - Fax:407-834-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty