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General NPI Number Information
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NPI Number | 1639941511
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Entity Type | Organization
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Legal Business Name | LCV QUALITY TALK SPEECH THERAPY CORPORATION
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 642 THIRD AVE STE M
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City | CHULA VISTA
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State | CA
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Zip | 91910-5734
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Country | US
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Telephone | 619-850-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 642 THIRD AVE STE M
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City | CHULA VISTA
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State | CA
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Zip | 91910-5734
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Country | US
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Telephone | 619-850-8802
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Fax |
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Authorized Official
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Title or Position | SPEECH AND LANGUAGE PATHOLOGIST
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Name | MRS. LIZA CRISTINA VIEJO
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Credential | M.S. CCC/SLP
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Telephone | 619-850-8802
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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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