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General NPI Number Information
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NPI Number | 1215165295
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Entity Type | Organization
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Legal Business Name | THE SPEECH HOUSE, SPEECH-LANGUAGE THERAPY, INC.
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 5611 PALMER WAY SUITE B
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City | CARLSBAD
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State | CA
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Zip | 92010-7253
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Country | US
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Telephone | 760-814-0179
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Fax |
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Provider Business Mailing Address
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Address Line | 5611 PALMER WAY SUITE B
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City | CARLSBAD
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State | CA
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Zip | 92010-7253
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Country | US
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Telephone | 760-814-0179
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Fax |
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Authorized Official
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Title or Position | OWNER, SPEECH-LANGUAGE PATHOLOGIST
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Name | BROOKE HARTMAN BARRETT
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Credential | M.S., CCC-SLP
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Telephone | 760-814-0179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 14536
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License Number State | CA
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