Provider Demographics
NPI:1497447007
Name:DSP HEALTH SPEECH
Entity Type:Organization
Organization Name:DSP HEALTH SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-305-3130
Mailing Address - Street 1:4051 BROAD ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-8722
Mailing Address - Country:US
Mailing Address - Phone:805-242-1617
Mailing Address - Fax:805-242-1617
Practice Address - Street 1:4051 BROAD ST STE 110
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-8722
Practice Address - Country:US
Practice Address - Phone:805-242-1617
Practice Address - Fax:805-242-1617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DSP HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech