Provider Demographics
NPI:1659019123
Name:SPEECH THERAPY VENUE INC
Entity Type:Organization
Organization Name:SPEECH THERAPY VENUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC
Authorized Official - Phone:805-587-9387
Mailing Address - Street 1:1230 MADERA RD STE 5
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4046
Mailing Address - Country:US
Mailing Address - Phone:805-587-9387
Mailing Address - Fax:
Practice Address - Street 1:450 COUNTRY CLUB DR APT C
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6647
Practice Address - Country:US
Practice Address - Phone:805-587-9387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty