Provider Demographics
NPI:1235862533
Name:GOLDEN OAK SPEECH THERAPY, A PROFESSIONAL SPEECH PATHOLOGY CORPORATION
Entity Type:Organization
Organization Name:GOLDEN OAK SPEECH THERAPY, A PROFESSIONAL SPEECH PATHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAECHAO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:510-875-8454
Mailing Address - Street 1:405 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2220
Mailing Address - Country:US
Mailing Address - Phone:510-875-8454
Mailing Address - Fax:
Practice Address - Street 1:405 SIERRA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2220
Practice Address - Country:US
Practice Address - Phone:510-875-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty