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General NPI Number Information
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NPI Number | 1962150805
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Entity Type | Organization
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Legal Business Name | MOBILE SPEECH THERAPY
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 11325 PARK SQUARE DR APT N106
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City | BAKERSFIELD
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State | CA
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Zip | 93311-8876
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Country | US
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Telephone | 661-379-0716
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22002
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City | BAKERSFIELD
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State | CA
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Zip | 93390-2002
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Country | US
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Telephone | 661-379-0716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHERINE HALLUM
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Credential | MS, CCC-SLP
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Telephone | 661-379-0716
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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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