Provider Demographics
NPI:1942980222
Name:MINDFUL SPEECH-LANGUAGE THERAPY, INC.
Entity Type:Organization
Organization Name:MINDFUL SPEECH-LANGUAGE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHIPARO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:323-350-6125
Mailing Address - Street 1:3620 MIDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3830
Mailing Address - Country:US
Mailing Address - Phone:323-350-6125
Mailing Address - Fax:
Practice Address - Street 1:3620 MIDVALE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-3830
Practice Address - Country:US
Practice Address - Phone:323-350-6125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty