Healthcare Provider Details

I. General information

NPI: 1528485893
Provider Name (Legal Business Name): ECHO SPEECH THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 ARDEN AVE STE 201
GLENDALE CA
91203-4006
US

IV. Provider business mailing address

410 ARDEN AVE STE 201
GLENDALE CA
91203-4006
US

V. Phone/Fax

Practice location:
  • Phone: 818-533-8929
  • Fax:
Mailing address:
  • Phone: 818-533-8929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSA CHING
Title or Position: CEO
Credential: MS CCC-SLP
Phone: 818-533-8929