Most Relevant Information
Provider Data
| NPI Number: | 1003314139 |
| Provider Name: | LIBBY JASMINE KING M.A., CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SA17060 |
Most Important Dates
| Enumeration Date: | 01/23/2018 |
| Last Updated: | 09/13/2019 |
Provider Practice Location
6550 N WICKHAM RD STE 8
MELBOURNE
FL
329402038
Practice Location Phone/Fax
| Phone: | 3214277373 |
| Fax: |
Provider Mailing Location
465 NEWFOUND HARBOR DR
MERRITT ISLAND
FL
329522655
Provider Mailing Phone/Fax
| Phone: | 3214277373 |
| Fax: |