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General NPI Number Information
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NPI Number | 1871986638
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Entity Type | Organization
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Legal Business Name | CONNECTED SPEECH THERAPY, INC.
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 2741 RIVERSIDE BLVD STE 2
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City | SACRAMENTO
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State | CA
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Zip | 95818
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Country | US
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Telephone | 916-426-6005
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Fax | 916-426-6005
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Provider Business Mailing Address
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Address Line | 2741 RIVERSIDE BLVD STE 2
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City | SACRAMENTO
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State | CA
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Zip | 95818-2900
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Country | US
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Telephone | 916-426-6005
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Fax | 916-426-6005
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Authorized Official
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Title or Position | OWNER/CEO
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Name | KIMBERLY DELANEY
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Credential | M.S., CCC-SLP
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Telephone | 916-792-6634
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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 | 18075
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License Number State | CA
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