MEDICARE: SPEECH ME, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP 15636	CA

General Provider Information

NPI Number	:	1588951776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH ME, LLC

Provider Business Mailing Address
First Line	:	3637 MOTOR AVE
Second Line	:	SUITE 300
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-5761
Country	:	US
Telephone Number	:	310-876-1110
Fax Number	:	310-876-1114

Provider Business Practice Location Address
First Line	:	3637 MOTOR AVE
Second Line	:	SUITE 300
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-5761
Country	:	US
Telephone Number	:	310-876-1110
Fax Number	:	310-876-1114

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name	:	HEATHER MARENDA
Credential	:	M.S., CCC-SLP
Telephone Number	:	310-876-1110

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	07/07/2011

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Directions to “SPEECH ME, LLC ” Practice Location

Language	Start Address	Practice Location

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