Provider Demographics
NPI:1568811800
Name:ZENITH SPEECH THERAPY INC
Entity Type:Organization
Organization Name:ZENITH SPEECH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP-CCC
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISHNAMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOTAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:949-903-8229
Mailing Address - Street 1:1 SOLANA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-4678
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17842 IRVINE BLVD, STE # 116/118
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3203
Practice Address - Country:US
Practice Address - Phone:949-903-8229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18852251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services