Provider Demographics
NPI:1114404613
Name:SIMBA, FARIDA (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:FARIDA
Middle Name:
Last Name:SIMBA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:MRS
Other - First Name:FARIDA
Other - Middle Name:
Other - Last Name:MUSAJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:641 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2127
Mailing Address - Country:US
Mailing Address - Phone:630-890-2330
Mailing Address - Fax:
Practice Address - Street 1:641 W 58TH ST
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2127
Practice Address - Country:US
Practice Address - Phone:630-890-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty