Provider Demographics
NPI:1568529212
Name:POST SPEECH PATHOLOGY, INC.
Entity Type:Organization
Organization Name:POST SPEECH PATHOLOGY, INC.
Other - Org Name:TUSTIN SPEECH AND LANGUAGE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POST
Authorized Official - Suffix:
Authorized Official - Credentials:SP5043
Authorized Official - Phone:714-838-2853
Mailing Address - Street 1:661 W 1ST ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2939
Mailing Address - Country:US
Mailing Address - Phone:714-838-2853
Mailing Address - Fax:714-838-4533
Practice Address - Street 1:661 W 1ST ST
Practice Address - Street 2:SUITE E
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2939
Practice Address - Country:US
Practice Address - Phone:714-838-2853
Practice Address - Fax:714-838-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT7446111NR0400X
CASP5043235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty