| Kingdom Therapy Llc | |
|
12550 Se 115th St Ocklawaha FL 32179-4821 | |
| (407) 922-3022 | |
| Not Available |
| Full Name | Kingdom Therapy Llc |
|---|---|
| Speciality | Speech-language Pathologist |
| Location | 12550 Se 115th St, Ocklawaha, Florida |
| Authorized Official Name and Position | Stephanie Marrero (OWNER) |
| Authorized Official Contact | 4079223022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Therapy Llc 12550 Se 115th St Ocklawaha FL 32179-4821 Ph: (407) 922-3022 | Kingdom Therapy Llc 12550 Se 115th St Ocklawaha FL 32179-4821 Ph: (407) 922-3022 |
| NPI Number | 1164307419 |
|---|---|
| Provider Enumeration Date | 08/06/2025 |
| Last Update Date | 08/12/2025 |
| Certification Date | 08/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164307419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |