Provider Demographics
NPI:1104499912
Name:KATARU SPEECH AND LANGUAGE, LLC
Entity type:Organization
Organization Name:KATARU SPEECH AND LANGUAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKEUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-387-1542
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-0172
Mailing Address - Country:US
Mailing Address - Phone:808-387-1542
Mailing Address - Fax:
Practice Address - Street 1:3644 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7560
Practice Address - Country:US
Practice Address - Phone:808-387-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech