MEDICARE: ON YOUR MARK SPEECH THERAPY

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1760168322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON YOUR MARK SPEECH THERAPY

Provider Business Mailing Address
First Line	:	4418 SPENCER ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-2434
Country	:	US
Telephone Number	:	585-610-7599
Fax Number	:

Provider Business Practice Location Address
First Line	:	4418 SPENCER ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-2434
Country	:	US
Telephone Number	:	585-610-7599
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH LANGUAGE PATHOLOGIST
Name	:	EMILY FARINACCI
Credential	:
Telephone Number	:	585-610-7599

Provider Enumeration Date	:	06/27/2023
Last Update Date	:	06/27/2023

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Directions to “ON YOUR MARK SPEECH THERAPY ” Practice Location

Language	Start Address	Practice Location

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