Provider Demographics
NPI:1043923287
Name:SOCIAL BUTTERFLY SPEECH LANGUAGE PATHOLOGY SERVICES, CORPORATION
Entity Type:Organization
Organization Name:SOCIAL BUTTERFLY SPEECH LANGUAGE PATHOLOGY SERVICES, CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOCE-CAMAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-501-4044
Mailing Address - Street 1:33432 ALVARADO NILES RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3110
Mailing Address - Country:US
Mailing Address - Phone:510-501-4044
Mailing Address - Fax:510-345-3023
Practice Address - Street 1:33432 ALVARADO NILES RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3110
Practice Address - Country:US
Practice Address - Phone:510-501-4044
Practice Address - Fax:510-345-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty