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1255855219
MIRLENE PRINCIPAL
ORANGE CITY, FL
NPI
1255855219
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: FL SA15089)
Enumeration Date
2017-08-01
Last Update Date
2017-08-01
Business Address
MIRLENE PRINCIPAL CCC-SLP
820 COMMED BLVD
ORANGE CITY, FL 32763-8321
Phone number: 386-775-7488
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Mailing Address
MIRLENE PRINCIPAL CCC-SLP
3901 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216-4312
Phone number: 904-345-7336
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