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General NPI Number Information
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NPI Number | 1568811800
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Entity Type | Organization
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Legal Business Name | ZENITH SPEECH THERAPY INC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 17842 IRVINE BLVD, STE # 116/118
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City | TUSTIN
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State | CA
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Zip | 92780-3203
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Country | US
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Telephone | 949-903-8229
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SOLANA
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City | IRVINE
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State | CA
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Zip | 92612-4678
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SLP-CCC
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Name | MRS. KRISHNAMALA THOTAPALLI
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Credential | M.S
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Telephone | 949-903-8229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 18852
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License Number State | CA
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