Provider Demographics
NPI:1821615253
Name:AMPLIFIED VOICE & SPEECH THERAPY INC.
Entity Type:Organization
Organization Name:AMPLIFIED VOICE & SPEECH THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:LE ROUX
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:760-230-4313
Mailing Address - Street 1:1465 CHERT DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2823
Mailing Address - Country:US
Mailing Address - Phone:760-230-4313
Mailing Address - Fax:
Practice Address - Street 1:1465 CHERT DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2823
Practice Address - Country:US
Practice Address - Phone:760-230-4313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech