1306392410 NPI number — RACHEL MADEL SPEECH THERAPY INC

Table of content: MS. LORI JAYNE COLLISON M.S. (NPI 1952329039)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306392410 NPI number — RACHEL MADEL SPEECH THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RACHEL MADEL SPEECH THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306392410
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3019 OCEAN PARK BLVD STE 700
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA MONICA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90405-3004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-832-0943
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
707 GRANT STREET
Provider Second Line Business Practice Location Address:
UNIT 15
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90405-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-832-0943
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MADEL
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
484-832-0943

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com