Provider Demographics
NPI:1336461383
Name:VITAL SPEECH AND SWALLOW SPEECH THERAPY, INC
Entity Type:Organization
Organization Name:VITAL SPEECH AND SWALLOW SPEECH THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHITNITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:818-708-7704
Mailing Address - Street 1:20720 VENTURA BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-6261
Mailing Address - Country:US
Mailing Address - Phone:818-708-7704
Mailing Address - Fax:818-708-7707
Practice Address - Street 1:20720 VENTURA BLVD STE 260
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-6261
Practice Address - Country:US
Practice Address - Phone:818-708-7704
Practice Address - Fax:818-708-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62697174400000X
CACCC9644235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty