Provider Demographics
NPI:1548655673
Name:TOLUCA SPEECH AND LANGUAGE INC.
Entity type:Organization
Organization Name:TOLUCA SPEECH AND LANGUAGE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH OAKLEY
Authorized Official - Middle Name:MS
Authorized Official - Last Name:CCC-SLP
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:747-477-1998
Mailing Address - Street 1:3800 W RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4323
Mailing Address - Country:US
Mailing Address - Phone:747-477-1998
Mailing Address - Fax:
Practice Address - Street 1:3800 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4323
Practice Address - Country:US
Practice Address - Phone:747-477-1998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20242235Z00000X
CA19729235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty