Provider Demographics
NPI:1841756582
Name:KFI SPEECH THERAPY, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:KFI SPEECH THERAPY, PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KYMRY
Authorized Official - Middle Name:HART
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC
Authorized Official - Phone:949-374-4868
Mailing Address - Street 1:127 AVENIDA SERRA APT B
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-6780
Mailing Address - Country:US
Mailing Address - Phone:949-374-4868
Mailing Address - Fax:888-420-6257
Practice Address - Street 1:27184 ORTEGA HWY STE 103
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2796
Practice Address - Country:US
Practice Address - Phone:949-374-4868
Practice Address - Fax:949-606-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty