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General NPI Number Information
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NPI Number | 1366222085
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Entity Type | Organization
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Legal Business Name | FORTE SPEECH & LANGUAGE THERAPY, INC.
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 12012 GOSHEN AVE APT 208
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City | LOS ANGELES
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State | CA
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Zip | 90049-6367
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Country | US
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Telephone | 484-332-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 4712 ADMIRALTY WAY STE 288
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6905
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Country | US
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Telephone | 484-332-0626
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAWN L KRUMHOLZ
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Credential |
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Telephone | 484-332-0626
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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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