| |
3208 Highland Ave Ste B, Manhattan Bch, CA 90266-3833 | |
(415) 713-9011 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Speech-language Pathologist |
Location | 3208 Highland Ave Ste B, Manhattan Bch, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184906463 | NPI | - | NPPES |
SP-13647 | Other | CA | SPEECH THERAPY LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | SP13647 (California) | Primary |
Mailing Address | Practice Location Address |
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3208 Highland Ave Ste B, Manhattan Bch, CA 90266-3833 Ph: (415) 713-9011 | 3208 Highland Ave Ste B, Manhattan Bch, CA 90266-3833 Ph: (415) 713-9011 |