Provider Demographics
NPI:1215932967
Name:SPELMAN, MILAURA BAUGHN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MILAURA
Middle Name:BAUGHN
Last Name:SPELMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:MILAURA
Other - Middle Name:ANN
Other - Last Name:BAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1155 LOUISIANA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2341
Mailing Address - Country:US
Mailing Address - Phone:407-792-9552
Mailing Address - Fax:407-539-2637
Practice Address - Street 1:1155 LOUISIANA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2341
Practice Address - Country:US
Practice Address - Phone:407-792-9552
Practice Address - Fax:407-539-2637
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-19
Last Update Date:2009-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist