Provider Demographics
NPI:1760260889
Name:MY SPEECH PATHOLOGY INC.
Entity Type:Organization
Organization Name:MY SPEECH PATHOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:973-945-9257
Mailing Address - Street 1:2001 S BARRINGTON AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5379
Mailing Address - Country:US
Mailing Address - Phone:424-279-8379
Mailing Address - Fax:310-432-2411
Practice Address - Street 1:2001 S BARRINGTON AVE STE 312
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5379
Practice Address - Country:US
Practice Address - Phone:424-279-8379
Practice Address - Fax:310-432-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty