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General NPI Number Information
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NPI Number | 1558740274
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Entity Type | Organization
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Legal Business Name | SPEECH THERAPY PARTNERS INCORPORATED
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 15901 HAWTHORNE BLVD #140
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City | LAWNDALE
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State | CA
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Zip | 90260
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Country | US
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Telephone | 424-257-1533
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Fax | 310-370-2339
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Provider Business Mailing Address
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Address Line | 15901 HAWTHORNE BLVD #140
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City | LAWNDALE
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State | CA
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Zip | 90260
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Country | US
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Telephone | 424-257-1533
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Fax | 310-370-2339
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JULIE KRISTIE CARRILLO
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Credential | M.A. CCC-SLP
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Telephone | 424-257-1533
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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 | SP 18425
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License Number State | CA
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Taxonomy #2
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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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