Provider Demographics
NPI:1851907281
Name:CHATTYKIDDO PEDIATRIC THERAPY A SPEECH PATHOLOGIST CORPORATION
Entity Type:Organization
Organization Name:CHATTYKIDDO PEDIATRIC THERAPY A SPEECH PATHOLOGIST CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ROMANCHUKEVICH
Authorized Official - Last Name:TIPAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:714-600-0688
Mailing Address - Street 1:2512 COVENTRY CIR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-1281
Mailing Address - Country:US
Mailing Address - Phone:714-600-0688
Mailing Address - Fax:877-595-1830
Practice Address - Street 1:1210 W IMPERIAL HWY STE D
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6962
Practice Address - Country:US
Practice Address - Phone:714-600-0688
Practice Address - Fax:877-595-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty