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Organization
LOS ANGELES SPEECH AND LANGUAGE THERAPY CENTER INC
Active
Organization
LOS ANGELES SPEECH AND LANGUAGE THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA SUE WILEY PH.D., CCC-SLP (OWNER-PRESIDENT/SLP)
(310) 649-6199
Entity
Organization
Contact information
Practice address
5761 BUCKINGHAM PKWY, CULVER CITY, CA 90230-6515
(310) 649-6199
(310) 649-5597
Mailing address
5761 BUCKINGHAM PKWY, CULVER CITY, CA 90230-6515
(310) 649-6199
(310) 649-5597
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP3380
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GSP000290
MEDI-CAL
CA
Enumeration date
01/15/2010
Last updated
09/29/2010
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