Provider Demographics
NPI:1942663455
Name:RECESS SPEECH THERAPY
Entity Type:Organization
Organization Name:RECESS SPEECH THERAPY
Other - Org Name:RECESS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST-DIRECTO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHUNYA
Authorized Official - Middle Name:CONNIE
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:626-226-9929
Mailing Address - Street 1:440 E. HUNTINGTON DR. #336
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-226-9929
Mailing Address - Fax:
Practice Address - Street 1:440 E HUNTINGTON DR # 336
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3776
Practice Address - Country:US
Practice Address - Phone:626-226-9929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty