Provider Demographics
NPI:1780085316
Name:HIGH DESERT SPEECH
Entity type:Organization
Organization Name:HIGH DESERT SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKIETA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EMANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP-D
Authorized Official - Phone:760-782-8884
Mailing Address - Street 1:16785 BEAR VALLEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-1423
Mailing Address - Country:US
Mailing Address - Phone:760-782-8884
Mailing Address - Fax:
Practice Address - Street 1:16785 BEAR VALLEY RD STE 2
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-1423
Practice Address - Country:US
Practice Address - Phone:760-782-8884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16142355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Single Specialty