Healthcare Provider Details
I. General information
NPI: 1205782778
Provider Name (Legal Business Name): THE GIGGLE GARDEN INCORPORATED SPEECH-LANGUAGE PATHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
698 WHITING ST STE G
GRASS VALLEY CA
95945-7568
US
IV. Provider business mailing address
25835 TABLE MEADOW RD
AUBURN CA
95602-8958
US
V. Phone/Fax
- Phone: 530-210-2447
- Fax:
- Phone: 916-410-5867
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRYSTAL
EZELL
Title or Position: CEO
Credential: SLP
Phone: 916-410-5867