Provider Demographics
NPI:1952875379
Name:KEYS TO COMMUNICATION SPEECH PATHOLOGY CORP
Entity Type:Organization
Organization Name:KEYS TO COMMUNICATION SPEECH PATHOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR/SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:MARIQUE
Authorized Official - Last Name:TONE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:408-314-7279
Mailing Address - Street 1:1156 SHADY DALE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008
Mailing Address - Country:US
Mailing Address - Phone:408-314-7279
Mailing Address - Fax:
Practice Address - Street 1:2020 FOREST AVE STE 7
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4805
Practice Address - Country:US
Practice Address - Phone:408-982-3240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty