Provider Demographics
NPI:1750586830
Name:THE VINEYARD SPEECH, LANGUAGE & READING SVS., INC.
Entity type:Organization
Organization Name:THE VINEYARD SPEECH, LANGUAGE & READING SVS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:AMBER
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:M A, CCC-SLP
Authorized Official - Phone:352-351-2281
Mailing Address - Street 1:2760 SE 17TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5571
Mailing Address - Country:US
Mailing Address - Phone:352-351-2281
Mailing Address - Fax:352-351-2285
Practice Address - Street 1:2760 SE 17TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5571
Practice Address - Country:US
Practice Address - Phone:352-351-2281
Practice Address - Fax:352-351-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty