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General NPI Number Information
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NPI Number | 1902617814
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Entity Type | Organization
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Legal Business Name | HEDGEHOG SPEECH THERAPY
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 1054 S DE ANZA BLVD STE 102
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City | SAN JOSE
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State | CA
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Zip | 95129-3553
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Country | US
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Telephone | 408-763-3697
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Fax |
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Provider Business Mailing Address
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Address Line | 10190 N FOOTHILL BLVD APT F9
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City | CUPERTINO
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State | CA
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Zip | 95014-0820
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Country | US
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Telephone | 408-841-6690
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Fax |
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Authorized Official
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Title or Position | OWNER & SPEECH LANGUAGE PATHOLOGIST
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Name | GRACE HEDGECOCK
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Credential | M.S., CCC-SLP
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Telephone | 408-841-6690
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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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