Healthcare Provider Details

I. General information

NPI: 1891238739
Provider Name (Legal Business Name): NATURALLY SPEAKING THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2016
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78034 CALLE BARCELONA SUITE A
LA QUINTA CA
92253-2997
US

IV. Provider business mailing address

78034 CALLE BARCELONA SUITE A
LA QUINTA CA
92253-2997
US

V. Phone/Fax

Practice location:
  • Phone: 760-600-5811
  • Fax: 760-600-5814
Mailing address:
  • Phone: 760-600-5811
  • Fax: 760-600-5814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number163
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number561
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2999
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3826
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22166
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number23986
License Number StateCA

VIII. Authorized Official

Name: MS. SHANITA EBERE
Title or Position: CEO/OWNER/SPEECH PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 773-414-6292