Provider Demographics
NPI:1154168789
Name:ELEVATE BEYOND SPEECH THERAPY, PC
Entity type:Organization
Organization Name:ELEVATE BEYOND SPEECH THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/SPEECH LANGUAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LIZBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:559-393-0045
Mailing Address - Street 1:3828 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-4522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3828 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-4522
Practice Address - Country:US
Practice Address - Phone:559-960-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty