Provider Demographics
NPI:1558842518
Name:SUMMIT SPEECH PATHOLOGY SERVICES INC.
Entity Type:Organization
Organization Name:SUMMIT SPEECH PATHOLOGY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC
Authorized Official - Phone:310-377-0169
Mailing Address - Street 1:2644 VIA OLIVERA
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-2810
Mailing Address - Country:US
Mailing Address - Phone:310-377-0169
Mailing Address - Fax:310-377-0182
Practice Address - Street 1:2644 VIA OLIVERA
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-2810
Practice Address - Country:US
Practice Address - Phone:310-377-0169
Practice Address - Fax:310-377-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty