THERAPY CONNECTION OF THE TREASURE COAST
Speech Language Pathology at Lake Whitney Pl, Fort Pierce, FL

License number
Florida SA10918
Category
Speech Language Pathology
Type
Speech-Language Pathologist
Owner
Name: MRS. JUSTINE THEISEN M.A. CCC-SLP
Title: OWNER
Phone: (772) 301-1207
Address
Address
549 NW Lake Whitney Pl SUITE 103, Fort Pierce, FL 34986
National Provider ID: 1124486949
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THERAPY CONNECTION OF THE TREASURE COAST PLLC

5811 Bamboo Dr, Fort Pierce, FL 34982

Registration:
Jul 23, 2014
State ID:
L14000115938
Business type:
Florida Limited Liability Company
Justine Taylor Theisen, 5811 Bamboo Dr, Fort Pierce, FL 34982 (Physical)
Agent:
Theisen , Jeremy,5811 Bamboo Dr, Fort Pierce, FL 34982 (Physical)
EIN:
47-1548044

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