Provider Demographics
NPI:1447670534
Name:EMPOWER SPEECH THERAPY AND LIFE SKILLS CENTER PC
Entity type:Organization
Organization Name:EMPOWER SPEECH THERAPY AND LIFE SKILLS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:559-801-2626
Mailing Address - Street 1:7170 N FINANCIAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2935
Mailing Address - Country:US
Mailing Address - Phone:559-801-2626
Mailing Address - Fax:559-314-6166
Practice Address - Street 1:7170 N FINANCIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2935
Practice Address - Country:US
Practice Address - Phone:559-801-2626
Practice Address - Fax:559-314-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 2355S0801X, 235Z00000X
CA20633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty