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General NPI Number Information
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NPI Number | 1972977213
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Entity Type | Organization
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Legal Business Name | SPLASH FOR SPEECH, INC.
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 3637 MOTOR AVENUE SUITE 280
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City | LOS ANGELES
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State | CA
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Zip | 90034-4884
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Country | US
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Telephone | 310-876-1110
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Fax | 310-876-1114
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Provider Business Mailing Address
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Address Line | 3637 MOTOR AVENUE SUITE 280
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City | LOS ANGELES
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State | CA
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Zip | 90034-4884
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Country | US
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Telephone | 310-876-1110
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Fax | 310-876-1114
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. AMY WILHELM
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Credential | M.S. CCC-SLP
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Telephone | 310-876-1110
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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 | SP13700
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License Number State | CA
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