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General NPI Number Information
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NPI Number | 1124806245
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Entity Type | Organization
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Legal Business Name | HOLISTIC SPEECH THERAPY
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 1450 HAUSER BLVD # 1450 1/2
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City | LOS ANGELES
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State | CA
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Zip | 90019-3969
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Country | US
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Telephone | 323-400-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 LINCOLN BLVD # 1162
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City | VENICE
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State | CA
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Zip | 90291-3503
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Country | US
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Telephone | 323-400-5209
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SONIA RUTH HILLER
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Credential | SLP
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Telephone | 323-400-5209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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