Provider Demographics
NPI:1841588084
Name:LANGUAGE AND SPEECH THERAPY
Entity Type:Organization
Organization Name:LANGUAGE AND SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:CHAU
Authorized Official - Last Name:DIEP
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:714-539-6207
Mailing Address - Street 1:12966 EUCLID ST STE 550
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-9217
Mailing Address - Country:US
Mailing Address - Phone:714-539-6207
Mailing Address - Fax:714-539-6209
Practice Address - Street 1:12966 EUCLID ST, SUITE 550
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-9217
Practice Address - Country:US
Practice Address - Phone:714-539-6207
Practice Address - Fax:714-539-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP12385252Y00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No305S00000XManaged Care OrganizationsPoint of Service