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General NPI Number Information
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NPI Number | 1073468146
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Entity Type | Organization
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Legal Business Name | OMW SPEECH PATHOLOGY SERVICES
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 22550 TOWN CIR STE TBD
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City | MORENO VALLEY
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State | CA
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Zip | 92553-7502
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Country | US
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Telephone | 909-951-5951
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Fax |
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Provider Business Mailing Address
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Address Line | 10260 PROSPECTOR LN
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City | MORENO VALLEY
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State | CA
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Zip | 92557-4238
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Country | US
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Telephone | 909-951-5951
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. KEISHA OMWANGHE
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Credential | M.C.D.,CCC-SLP
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Telephone | 909-951-5951
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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 |
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License Number State |
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