Provider Demographics
NPI:1427592815
Name:VOCAL TRACK SPEECH & LANGUAGE THERAPY CENTER INC
Entity Type:Organization
Organization Name:VOCAL TRACK SPEECH & LANGUAGE THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH & LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:GRASSO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC
Authorized Official - Phone:858-521-8446
Mailing Address - Street 1:16466 BERNARDO CENTER DR STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2529
Mailing Address - Country:US
Mailing Address - Phone:858-521-8446
Mailing Address - Fax:
Practice Address - Street 1:16466 BERNARDO CENTER DR STE 116
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2529
Practice Address - Country:US
Practice Address - Phone:858-521-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
CASP 21682251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty