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General NPI Number Information
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NPI Number | 1346487089
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Entity Type | Organization
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Legal Business Name | THE SPEECH & LANGUAGE GROUP, INC.
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 1930 WILSHIRE BLVD STE 904
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City | LOS ANGELES
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State | CA
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Zip | 90057-3619
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Country | US
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Telephone | 213-353-9019
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Fax | 213-353-0336
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Provider Business Mailing Address
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Address Line | 1930 WILSHIRE BLVD STE 904
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City | LOS ANGELES
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State | CA
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Zip | 90057-3619
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Country | US
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Telephone | 213-353-9019
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Fax | 213-353-0336
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. NICOLE RENEE VIGIL-OLSIN
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Credential | MA, CCC-SLP
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Telephone | 213-353-9019
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 11518
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License Number State | CA
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