Provider Demographics
NPI:1881332567
Name:HUES SPEECH THERAPY SERVICES CORPORATION
Entity type:Organization
Organization Name:HUES SPEECH THERAPY SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAQUILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:562-314-7174
Mailing Address - Street 1:550 S PALOS VERDES ST APT 204
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-5107
Mailing Address - Country:US
Mailing Address - Phone:562-314-7174
Mailing Address - Fax:
Practice Address - Street 1:550 S PALOS VERDES ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-5107
Practice Address - Country:US
Practice Address - Phone:213-577-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech