Provider Demographics
NPI:1538676390
Name:SPEECH FOR YOUNG TALKERS
Entity Type:Organization
Organization Name:SPEECH FOR YOUNG TALKERS
Other - Org Name:LINDA LARUE, M.A., CCC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARUE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:818-436-9381
Mailing Address - Street 1:5408 FRANCISCA WAY
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-5204
Mailing Address - Country:US
Mailing Address - Phone:818-436-9381
Mailing Address - Fax:
Practice Address - Street 1:19520 NORDHOFF ST STE 18
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2443
Practice Address - Country:US
Practice Address - Phone:818-436-9381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7226235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty