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General NPI Number Information
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NPI Number | 1558186221
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Entity Type | Organization
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Legal Business Name | BRIGHTPATH PEDIATRIC SPEECH THERAPY, P.C.
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 9377 HAVEN AVE STE 200
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5340
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Country | US
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Telephone | 909-206-4205
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Fax |
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Provider Business Mailing Address
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Address Line | 7922 DAY CREEK BLVD APT 4213
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-8589
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Country | US
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Telephone | 909-637-1738
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | CINTHIA JACINTO TORRES
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Credential | M.S., CCC-SLP
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Telephone | 909-637-1738
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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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