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General NPI Number Information
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NPI Number | 1346823325
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Entity Type | Organization
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Legal Business Name | BAKERSFIELD SPEECH THERAPY INC
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 4550 PANAMA LN STE 100
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City | BAKERSFIELD
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State | CA
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Zip | 93313-3486
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Country | US
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Telephone | 818-943-0704
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Fax | 661-742-1644
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Provider Business Mailing Address
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Address Line | 2205 GAMBEL OAK WAY
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City | BAKERSFIELD
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State | CA
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Zip | 93311-1690
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Country | US
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Telephone | 661-631-2229
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Fax | 661-742-1644
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Authorized Official
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Title or Position | CEO
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Name | BIDYARANI SHAMURAILATPAM
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Credential | SLP
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Telephone | 661-631-2229
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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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