Provider Demographics
NPI:1467199018
Name:THE SPEECH PATH SPEECH AND LANGUAGE THERAPY INC
Entity Type:Organization
Organization Name:THE SPEECH PATH SPEECH AND LANGUAGE THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CCC-SLP
Authorized Official - Phone:516-592-9338
Mailing Address - Street 1:889 CORBETT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1376
Mailing Address - Country:US
Mailing Address - Phone:516-592-9338
Mailing Address - Fax:
Practice Address - Street 1:889 CORBETT AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-1376
Practice Address - Country:US
Practice Address - Phone:516-592-9338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty