Provider Demographics
NPI:1154592335
Name:A PLUS SPEECH THERAPY PROFESSIONALS, INC.
Entity type:Organization
Organization Name:A PLUS SPEECH THERAPY PROFESSIONALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TISHUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TULLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:772-464-3303
Mailing Address - Street 1:4202 OKEECHOBEE RD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-5414
Mailing Address - Country:US
Mailing Address - Phone:772-462-6636
Mailing Address - Fax:772-462-6635
Practice Address - Street 1:1801 S 23RD ST STE 2
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4830
Practice Address - Country:US
Practice Address - Phone:772-464-3303
Practice Address - Fax:772-462-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 235Z00000X
FLSA5222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892824000Medicaid