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General NPI Number Information
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NPI Number | 1780085316
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Entity Type | Organization
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Legal Business Name | HIGH DESERT SPEECH
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 16785 BEAR VALLEY RD STE 2
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City | HESPERIA
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State | CA
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Zip | 92345-1423
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Country | US
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Telephone | 760-782-8884
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Fax |
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Provider Business Mailing Address
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Address Line | 16785 BEAR VALLEY RD STE 2
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City | HESPERIA
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State | CA
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Zip | 92345-1423
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Country | US
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Telephone | 760-782-8884
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Fax |
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Authorized Official
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Title or Position | SLP
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Name | DR. LAKIETA L EMANUEL
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Credential | CCC-SLP-D
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Telephone | 760-782-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number | 1614
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License Number State | CA
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