Provider Demographics
NPI:1164835302
Name:NAPA VALLEY SPEECH THERAPY, INC.
Entity Type:Organization
Organization Name:NAPA VALLEY SPEECH THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:707-967-1087
Mailing Address - Street 1:1360 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1905
Mailing Address - Country:US
Mailing Address - Phone:707-967-1087
Mailing Address - Fax:707-967-1098
Practice Address - Street 1:1360 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1905
Practice Address - Country:US
Practice Address - Phone:707-967-1087
Practice Address - Fax:707-967-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP16456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty