Provider Demographics
NPI:1326848987
Name:IMPACT SPEECH THERAPY INC
Entity type:Organization
Organization Name:IMPACT SPEECH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-961-6090
Mailing Address - Street 1:60 DECLARATION DR STE D
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4920
Mailing Address - Country:US
Mailing Address - Phone:530-961-6090
Mailing Address - Fax:
Practice Address - Street 1:60 DECLARATION DR STE D
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4920
Practice Address - Country:US
Practice Address - Phone:530-961-6090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech