Provider Demographics
NPI:1801140819
Name:SENSEABILITIES A PROFESSIONAL SPEECH THERAPY CORP
Entity type:Organization
Organization Name:SENSEABILITIES A PROFESSIONAL SPEECH THERAPY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOYD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-779-1966
Mailing Address - Street 1:5945 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1800
Mailing Address - Country:US
Mailing Address - Phone:951-779-1966
Mailing Address - Fax:951-779-1933
Practice Address - Street 1:5945 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1800
Practice Address - Country:US
Practice Address - Phone:951-779-1966
Practice Address - Fax:951-779-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18295235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty