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Organization
PROSTAR SPEECH THERAPY
Active
Organization
PROSTAR SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SADAF ROODBAEI (PRESIDENT)
(610) 327-7202
Entity
Organization
Contact information
Practice address
9171 WILSHIRE BLVD, BEVERLY HILLS, CA 90210-5530
(310) 935-0030
Mailing address
9171 WILSHIRE BLVD, BEVERLY HILLS, CA 90210-5530
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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