Healthcare Provider Details

I. General information

NPI: 1245165638
Provider Name (Legal Business Name): CUE SPEECH & LANGUAGE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 SUSAN LEE LN
MODESTO CA
95350-0931
US

IV. Provider business mailing address

917 SUSAN LEE LN
MODESTO CA
95350-0931
US

V. Phone/Fax

Practice location:
  • Phone: 209-204-2987
  • Fax:
Mailing address:
  • Phone: 209-204-2987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MARISSA ROSE FORD
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: SLP M.S CCC
Phone: 202-204-2987