SPEECH THERAPY MARIN

1058 REDWOOD HWY FRONTAGE RD STE A, MILL VALLEY, CA, 949411660

atlas:atm_npi_1205338332

Block 4006Block Group 4Census Tract 1241Marin County California United States

What is stored

phone: 415-924-2444
status: A
address: 1058 REDWOOD HWY FRONTAGE RD STE A, MILL VALLEY, CA, 949411660
fax: 415-924-2442
npi: 1205338332
license: 16970
taxonomy: Speech-Language Pathologist,
other names: ["CHILD DEVELOPMENT CENTER OF MARIN","SPEECH, MARIN"]
last updated: 2024-03-06
license state: CA
taxonomy code: 235Z00000X
all taxonomies: ["Speech-Language Pathologist, "]
enumeration date: 2018-03-05
enumeration type: NPI-2
practice locations: 0
authorized official: DENISE FORD
organizational subpart: NO

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Read fact fields

{
  "fax": "415-924-2442",
  "npi": "1205338332",
  "phone": "415-924-2444",
  "status": "A",
  "address": "1058 REDWOOD HWY FRONTAGE RD STE A, MILL VALLEY, CA, 949411660",
  "license": "16970",
  "taxonomy": "Speech-Language Pathologist,  ",
  "other_names": [
    "CHILD DEVELOPMENT CENTER OF MARIN",
    "SPEECH, MARIN"
  ],
  "last_updated": "2024-03-06",
  "license_state": "CA",
  "taxonomy_code": "235Z00000X",
  "all_taxonomies": [
    "Speech-Language Pathologist,  "
  ],
  "enumeration_date": "2018-03-05",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "DENISE FORD",
  "organizational_subpart": "NO"
}