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Organization
TBNI
Active
Organization
TBNI
Active
Other names
THERAPRISE
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARDO ENRIQUE DI GIACOMO (CFO)
(714) 989-6474
Entity
Organization
Contact information
Practice address
3702 ROADRUNNER DR, BREA, CA 92823-1002
(714) 989-6474
(714) 200-0234
Mailing address
3702 ROADRUNNER DR, BREA, CA 92823-1002
(714) 989-6474
(714) 200-0234
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/28/2011
Last updated
02/28/2011
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