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General NPI Number Information
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NPI Number | 1942442835
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Entity Type | Organization
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Legal Business Name | CATALYST SLP
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 205 S BROADWAY STE 217
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City | LOS ANGELES
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State | CA
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Zip | 90012-3607
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Country | US
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Telephone | 213-346-9945
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Fax | 866-820-1703
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Provider Business Mailing Address
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Address Line | 205 S BROADWAY STE 217
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City | LOS ANGELES
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State | CA
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Zip | 90012-3607
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Country | US
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Telephone | 213-346-9945
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Fax | 866-820-1703
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Authorized Official
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Title or Position | OWNER/SLP
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Name | MS. JI SOO KIM
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Credential | M.S.,CCC-SLP
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Telephone | 213-346-9945
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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 | 10983
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License Number State | CA
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