Healthcare Provider Details

I. General information

NPI: 1225492820
Provider Name (Legal Business Name): SPEACHY LEARNING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2016
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1164 CHESTNUT STREET
MENLO PARK CA
94025
US

IV. Provider business mailing address

P.O. BOX 636
MENLO PARK CA
94026
US

V. Phone/Fax

Practice location:
  • Phone: 844-773-2249
  • Fax:
Mailing address:
  • Phone: 844-773-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MAYRA L CRAMER
Title or Position: OWNER, CEO
Credential: CCC-SLP
Phone: 844-773-2249