Provider Demographics
NPI:1467654749
Name:WOODLAND HILLS CALABASAS SPEECH AND LANGUAGE CENTER
Entity Type:Organization
Organization Name:WOODLAND HILLS CALABASAS SPEECH AND LANGUAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:SANDERS
Authorized Official - Last Name:HARWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:818-224-2025
Mailing Address - Street 1:23241 VENTURA BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1048
Mailing Address - Country:US
Mailing Address - Phone:818-224-2025
Mailing Address - Fax:818-224-4306
Practice Address - Street 1:23241 VENTURA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1048
Practice Address - Country:US
Practice Address - Phone:818-224-2025
Practice Address - Fax:818-224-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP3330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty