Provider Demographics
NPI:1225552060
Name:SPEECHFUL THERAPY SERVICES
Entity Type:Organization
Organization Name:SPEECHFUL THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA DEL PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARI
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:562-991-4144
Mailing Address - Street 1:4306 OBISPO AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3700
Mailing Address - Country:US
Mailing Address - Phone:562-991-4144
Mailing Address - Fax:
Practice Address - Street 1:2700 N BELLFLOWER BLVD STE 112
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1100
Practice Address - Country:US
Practice Address - Phone:562-991-4144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17540235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710002621OtherSPEECH LANGUAGE PATHOLOGY