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Organization
GENERATION SPEECH THERAPY, INC.
Active
Organization
GENERATION SPEECH THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON BROUSSALIAN M.S., CCC-SLP (OWNER/SPEECH-LANGAUGE PATHOLOGIST)
(818) 915-1966
Entity
Organization
Contact information
Practice address
11150 BERTRAND AVE, GRANADA HILLS, CA 91344-4005
(818) 915-1966
Mailing address
11150 BERTRAND AVE, GRANADA HILLS, CA 91344-4005
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
CA
261QH0700X
Hearing and Speech Clinic/Center
—
CA
Other
Enumeration date
04/28/2018
Last updated
04/28/2018
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