Dettmore, Geanine L

Dettmore, Geanine L is an sole proprietor health care provider with primary practice located at 1119 Shadowbrook Trl , Winter Springs FL 32708-6323. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Dettmore, Geanine L can be contacted via phone (407) 247-8291.

Contact Information

Primary practice address
1119 Shadowbrook Trl Winter Springs FL 32708-6323
Phone: (407) 247-8291
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA 7685 Florida

Profile Details

NPI number 1023067998
LBN Legal business name Dettmore, Geanine L
Credentials M.A.,CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2006
Last updated Feb 23rd, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023067998 NPPES
Florida MEDICAID 889 365 900

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