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General NPI Number Information
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NPI Number | 1619781598
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Entity Type | Organization
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Legal Business Name | DYSPHAGIA SOLUTIONS LA SPEECH PATHOLOGY INC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1135 CARDIFF AVENUE
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 818-456-8439
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Fax |
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Provider Business Mailing Address
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Address Line | 324 S BEVERLY DR # 1126
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4822
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Country | US
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Telephone | 818-456-8439
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Fax |
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Authorized Official
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Title or Position | OWNER, SLP, ENDOSCOPIST
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Name | SASHA GROSSMAN
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Credential | M.S., CCC-SLP
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Telephone | 323-910-2506
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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 |
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License Number State |
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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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