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General NPI Number Information
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NPI Number | 1750872818
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Entity Type | Organization
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Legal Business Name | DISCOVERY SPEECH AND LANGUAGE PATHOLOGY
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 315 E COTATI AVE STE F
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City | COTATI
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State | CA
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Zip | 94931-7801
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Country | US
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Telephone | 635-487-0732
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Fax |
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Provider Business Mailing Address
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Address Line | 315 E COTATI AVE STE F
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City | COTATI
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State | CA
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Zip | 94931-7801
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Country | US
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Telephone | 707-326-3548
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Fax | 707-326-3548
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | KATIE JOSEPHINE WERLE
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Credential | M.S. CCC SLP
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Telephone | 707-326-3548
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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 | 18913
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License Number State | CA
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