Provider Demographics
NPI:1093538753
Name:AMBA SPEECH AND LANGUAGE CENTER, LLC
Entity type:Organization
Organization Name:AMBA SPEECH AND LANGUAGE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NIPA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:425-287-7689
Mailing Address - Street 1:8213 233RD PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-1985
Mailing Address - Country:US
Mailing Address - Phone:425-287-7689
Mailing Address - Fax:
Practice Address - Street 1:8213 233RD PL NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-1985
Practice Address - Country:US
Practice Address - Phone:425-287-7689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty