| Cobalt Therapy, Llc | |
|
510 Co Rd 466, Suite 204-e And 203-l, Lady Lake, FL 32159-4202 | |
| (352) 508-7789 | |
| (352) 855-0459 |
| Full Name | Cobalt Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 510 Co Rd 466, Lady Lake, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821623737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Ann-marie Alice Dykstra |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1831436203 PECOS PAC ID: 5395174239 Enrollment ID: I20200329000256 |
| Provider Name | Christina Renee Gwyn |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1538789250 PECOS PAC ID: 7214324284 Enrollment ID: I20220420003016 |
| Provider Name | Michelle Siller |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1205284361 PECOS PAC ID: 7911377809 Enrollment ID: I20230111000723 |
| Provider Name | Ashley Nicole Dehaven |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164058749 PECOS PAC ID: 7214384072 Enrollment ID: I20231115003492 |
| Provider Name | Susan Caroline Okamoto |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1679213409 PECOS PAC ID: 5890222574 Enrollment ID: I20241218004104 |
| Provider Name | Emily Weitekamp |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1861208258 PECOS PAC ID: 7012446990 Enrollment ID: I20250122000820 |
| Mailing Address | Practice Location Address |
|---|---|
| Cobalt Therapy, Llc 1303 Limit Ave Ste 201, Mount Dora, FL 32757-3135 Ph: (352) 818-7368 | Cobalt Therapy, Llc 510 Co Rd 466, Suite 204-e And 203-l, Lady Lake, FL 32159-4202 Ph: (352) 508-7789 |
Mica Collins Booth, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 630 Griffin Ave, Lady Lake, FL 32159 Phone: 352-750-6619 | |
Kathleen Harvey, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13940 N Us Highway 441, Building 600, Suite 603, Lady Lake, FL 32159 Phone: 352-751-1095 | |
Wendy H Doskocz, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4435 Lemon St, Lady Lake, FL 32159 Phone: 407-491-4470 | |
Jonathon Schwartz, ST Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13940 Hwy 441, Bldg 700 Suite 702, Lady Lake, FL 32159 Phone: 352-751-6005 | |
Sharon Martin, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 930 Co Rd. 466, Lady Lake, FL 32162 Phone: 404-405-2168 |