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General NPI Number Information
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NPI Number | 1306621735
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Entity Type | Organization
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Legal Business Name | THERAPY BUBBLE: SPEECH LANGUAGE PATHOLOGY SERVICES CORP
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 10472 PAGO PAGO CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3026
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Country | US
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Telephone | 657-329-9807
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Fax |
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Provider Business Mailing Address
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Address Line | 10472 PAGO PAGO CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3026
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Country | US
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Telephone | 657-329-9807
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/CO-DIRECTOR
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Name | GABRIELA CORTEZ
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Credential | SLP
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Telephone | 714-594-8719
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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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