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General NPI Number Information
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NPI Number | 1427708809
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Entity Type | Organization
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Legal Business Name | ALLIEMSLP SPEECH THERAPY GROUP INC
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 520 ELM ST # 24
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City | SAN CARLOS
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State | CA
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Zip | 94070-2249
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Country | US
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Telephone | 630-715-9696
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Fax |
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Provider Business Mailing Address
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Address Line | 520 ELM ST # 24
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City | SAN CARLOS
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State | CA
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Zip | 94070-2249
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Country | US
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Telephone | 630-715-9696
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA GLAZER
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Credential | M.S.CCC-SLP/L
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Telephone | 630-715-9696
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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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