Provider Demographics
NPI:1457114886
Name:VIRTUAL SPEECH THERAPY SOLUTIONS, INC
Entity Type:Organization
Organization Name:VIRTUAL SPEECH THERAPY SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHASHA
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:909-654-4062
Mailing Address - Street 1:41176 GUAVA ST STE A
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9146
Mailing Address - Country:US
Mailing Address - Phone:909-654-4062
Mailing Address - Fax:951-524-7932
Practice Address - Street 1:41176 GUAVA ST STE A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9146
Practice Address - Country:US
Practice Address - Phone:909-654-4062
Practice Address - Fax:951-524-7932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty