Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Audrey Petersen, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1336694892

Audrey Petersen, CCC-SLP is a Speech-Language Pathologist in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2016.

Licensed in
FL
In the registry since
2016
Specialties on file
2
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone: (904) 886-3228
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA15457 (FL)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SZ7762 (FL)

Record details

NPI number1336694892
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorNo
NPI enumeratedAugust 24, 2016
Last updated in NPPESSeptember 30, 2021
Certification dateSeptember 30, 2021
Mailing address12276 San Jose Blvd Ste 508, Jacksonville, FL 32223-8618

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