Provider Demographics
NPI:1639941511
Name:LCV QUALITY TALK SPEECH THERAPY CORPORATION
Entity Type:Organization
Organization Name:LCV QUALITY TALK SPEECH THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:VIEJO
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC/SLP
Authorized Official - Phone:619-850-8802
Mailing Address - Street 1:642 THIRD AVE STE M
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5734
Mailing Address - Country:US
Mailing Address - Phone:619-850-8802
Mailing Address - Fax:
Practice Address - Street 1:642 THIRD AVE STE M
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5734
Practice Address - Country:US
Practice Address - Phone:619-850-8802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty