Provider Demographics
NPI:1154534600
Name:FIRBY, RENEE (MSC, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:FIRBY
Suffix:
Gender:F
Credentials:MSC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 E OCEAN BLVD STE 440
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4806
Mailing Address - Country:US
Mailing Address - Phone:888-808-7838
Mailing Address - Fax:
Practice Address - Street 1:249 E OCEAN BLVD STE 440
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4806
Practice Address - Country:US
Practice Address - Phone:888-808-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15190235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist