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Organization
SOCAL SPEECH THERAPY & SWALLOWING DIAGNOSTICS INC.
Active
Organization
SOCAL SPEECH THERAPY & SWALLOWING DIAGNOSTICS INC.
Active
Other names
SoCal Speech Therapy & Swallowing Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN JOSEPH MILLER MA (ADMINISTRATOR)
(818) 824-3070
Entity
Organization
Contact information
Practice address
4383 TUJUNGA AVE STE J, STUDIO CITY, CA 91604-2771
(818) 824-3070
(818) 301-3282
Mailing address
11239 VENTURA BLVD STE 103, STUDIO CITY, CA 91604-3164
(818) 824-3070
(818) 301-3282
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502895
—
CA
Enumeration date
03/01/2022
Last updated
09/01/2026
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