Provider Demographics
NPI:1639480395
Name:BEZDENY SPEECH PATHOLOGY CLINIC
Entity Type:Organization
Organization Name:BEZDENY SPEECH PATHOLOGY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEZDENY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC/SLP
Authorized Official - Phone:818-884-5103
Mailing Address - Street 1:19730 VENTURA BLVD STE 103B
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2625
Mailing Address - Country:US
Mailing Address - Phone:818-884-5103
Mailing Address - Fax:818-884-5369
Practice Address - Street 1:19730 VENTURA BLVD STE 103B
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2625
Practice Address - Country:US
Practice Address - Phone:818-884-5103
Practice Address - Fax:818-884-5369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty