Provider Demographics
NPI:1063150910
Name:THRIVE SPEECH & FEEDING THERAPY
Entity type:Organization
Organization Name:THRIVE SPEECH & FEEDING THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:KATHARINE
Authorized Official - Last Name:FAIRBAIRN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:424-225-1481
Mailing Address - Street 1:3858 W CARSON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6705
Mailing Address - Country:US
Mailing Address - Phone:818-324-2292
Mailing Address - Fax:
Practice Address - Street 1:3858 W CARSON ST STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6705
Practice Address - Country:US
Practice Address - Phone:818-324-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-21
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty