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General NPI Number Information
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NPI Number | 1043729403
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Entity Type | Organization
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Legal Business Name | SPEECH TIME
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 2101 N GLENOAKS BLVD
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City | BURBANK
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State | CA
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Zip | 91504-2828
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Country | US
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Telephone | 818-522-5651
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Fax |
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Provider Business Mailing Address
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Address Line | 12435 NUGENT DR
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City | GRANADA HILLS
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State | CA
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Zip | 91344-1534
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Country | US
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Telephone | 818-522-9220
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/THERAPIST
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Name | PAITSAR ZHAMKOCHYAN
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Credential |
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Telephone | 818-522-5651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 15124
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License Number State | CA
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