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General NPI Number Information
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NPI Number | 1578894846
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Entity Type | Organization
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Legal Business Name | E. CHERYL FLETCHER SPEECH PATHOLOGY & ASSOCIATES
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 150 VALLEY VISTA DR
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City | CAMARILLO
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State | CA
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Zip | 93010-1725
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Country | US
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Telephone | 805-484-1671
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Fax | 805-987-0667
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Provider Business Mailing Address
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Address Line | 150 VALLEY VISTA DR
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City | CAMARILLO
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State | CA
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Zip | 93010-1725
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Country | US
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Telephone | 805-484-1671
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Fax | 805-987-0667
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELISABETH CHERYL FLETCHER
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Credential | MACCC
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Telephone | 805-484-1671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | SP 3002
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License Number State | CA
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