Provider Demographics
NPI:1124757356
Name:LOFTIS, GENAYA ANN
Entity type:Individual
Prefix:
First Name:GENAYA
Middle Name:ANN
Last Name:LOFTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25000 PORTOFINO CIR APT 109
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-1269
Mailing Address - Country:US
Mailing Address - Phone:860-867-0365
Mailing Address - Fax:
Practice Address - Street 1:25000 PORTOFINO CIR APT 109
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-1269
Practice Address - Country:US
Practice Address - Phone:860-867-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty