Provider Demographics
NPI: | 1982480224 |
---|---|
Name: | LOVE WITHOUT WORDS SPEECH THERAPY, CORP. |
Entity type: | Organization |
Organization Name: | LOVE WITHOUT WORDS SPEECH THERAPY, CORP. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SPEECH PATHOLOGIST/OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | ANDREA |
Authorized Official - Middle Name: | MARIE |
Authorized Official - Last Name: | GINGRAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | CCC-SLP |
Authorized Official - Phone: | 925-446-0969 |
Mailing Address - Street 1: | 1255 SHAKESPEARE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | CONCORD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94521-3367 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 925-446-0969 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1255 SHAKESPEARE DR |
Practice Address - Street 2: | |
Practice Address - City: | CONCORD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94521-3367 |
Practice Address - Country: | US |
Practice Address - Phone: | 925-446-0969 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-09-04 |
Last Update Date: | 2023-09-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Single Specialty |