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General NPI Number Information
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NPI Number | 1396506424
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Entity Type | Organization
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Legal Business Name | EARLY EXPRESSIONS SPEECH-LANGUAGE PATHOLOGY, INC.
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 2429 MANDARIN DR
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City | FAIRFIELD
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State | CA
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Zip | 94533-7139
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Country | US
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Telephone | 707-450-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 2429 MANDARIN DR
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City | FAIRFIELD
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State | CA
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Zip | 94533-7139
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Country | US
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Telephone | 707-450-1516
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MONICA PORTIGLIATTI POMERI
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Credential | M.S. CCC-SLP
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Telephone | 707-450-1516
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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 |
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License Number State |
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