Healthcare Provider Details

I. General information

NPI: 1639711138
Provider Name (Legal Business Name): LINK SPEECH THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CROW CANYON CT STE 110
SAN RAMON CA
94583-1975
US

IV. Provider business mailing address

136 COUNTRYBROOK LOOP
SAN RAMON CA
94583-4473
US

V. Phone/Fax

Practice location:
  • Phone: 559-801-7648
  • Fax:
Mailing address:
  • Phone: 559-801-7648
  • 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: LAURA DODD
Title or Position: OWNER/SPEECH-LANGUAGE PATHOLOGIST
Credential:
Phone: 925-232-1043