Provider Demographics
NPI:1295598209
Name:BOLDLY COMMUNICATING AAC, SPEECH, & LANGUAGE THERAPY INC.
Entity type:Organization
Organization Name:BOLDLY COMMUNICATING AAC, SPEECH, & LANGUAGE THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:415-569-0145
Mailing Address - Street 1:318 HOLYOKE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-1442
Mailing Address - Country:US
Mailing Address - Phone:858-337-0790
Mailing Address - Fax:
Practice Address - Street 1:2211 POST ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3442
Practice Address - Country:US
Practice Address - Phone:858-337-0790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech