MEDICARE: INTERACT SPEECH-LANGUAGE PATHOLOGY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1184512196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERACT SPEECH-LANGUAGE PATHOLOGY INC.

Provider Business Mailing Address
First Line	:	6314 FRIARS RD UNIT 306
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6314 FRIARS RD UNIT 306
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1016
Country	:	US
Telephone Number	:	804-357-6683
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	DR. DOROTHY YANG
Credential	:	PHD, CCC-SLP
Telephone Number	:	804-357-6683

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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