Provider Demographics
NPI:1336962190
Name:STORY SPEECH THERAPY
Entity type:Organization
Organization Name:STORY SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD SLP
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KOCSIS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:714-309-2019
Mailing Address - Street 1:1530 EISENHOWER DR APT 308
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1285
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1530 EISENHOWER DR APT 308
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1285
Practice Address - Country:US
Practice Address - Phone:714-309-2019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty