Provider Demographics
NPI:1073874764
Name:APPLIED SPEECH COMMUNICATION
Entity Type:Organization
Organization Name:APPLIED SPEECH COMMUNICATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLPD
Authorized Official - Phone:209-544-1032
Mailing Address - Street 1:3117 MCHENRY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1470
Mailing Address - Country:US
Mailing Address - Phone:209-544-1032
Mailing Address - Fax:209-491-7184
Practice Address - Street 1:3117 MCHENRY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-1470
Practice Address - Country:US
Practice Address - Phone:209-544-1032
Practice Address - Fax:209-491-7184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12114980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty