Provider Demographics
NPI:1164104774
Name:PAWSITIVE SPEECH THERAPY, INC.
Entity Type:Organization
Organization Name:PAWSITIVE SPEECH THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:NANCE
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:714-873-8947
Mailing Address - Street 1:13022 ETHELBEE WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-1806
Mailing Address - Country:US
Mailing Address - Phone:760-567-2802
Mailing Address - Fax:
Practice Address - Street 1:17601 17TH ST STE 215
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-1946
Practice Address - Country:US
Practice Address - Phone:714-873-8947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty