MEDICARE: CLARION SPEECH AND LANGUAGE SERVICES, 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	252Y00000X	Early Intervention Provider Agency	12003007	CA

General Provider Information

NPI Number	:	1891044798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARION SPEECH AND LANGUAGE SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4436
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-4436
Country	:	US
Telephone Number	:	310-637-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 W COMPTON BLVD
Second Line	:	SUITE 101
City	:	COMPTON
State	:	CA
Zip	:	90220-3085
Country	:	US
Telephone Number	:	310-637-1010
Fax Number	:	310-637-1414

Authorized Official
Title or Position	:	CEO
Name	:	MS. LETHE WARD
Credential	:	M.A. CCCSP 6069
Telephone Number	:	213-804-2516

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	09/06/2012

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