Provider Demographics
NPI:1558133413
Name:GUENTHER, DYLAN (BA, SLPA)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:GUENTHER
Suffix:
Gender:M
Credentials:BA, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 GARDEN GROVE BLVD STE M
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4209
Mailing Address - Country:US
Mailing Address - Phone:714-799-3030
Mailing Address - Fax:800-887-9554
Practice Address - Street 1:7441 GARDEN GROVE BLVD STE M
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4209
Practice Address - Country:US
Practice Address - Phone:714-799-3030
Practice Address - Fax:800-887-9554
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71172355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant