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Organization

PROSTAR SPEECH THERAPY

Active
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Organization

PROSTAR SPEECH THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SADAF ROODBAEI (PRESIDENT)
(631) 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
09/13/2019
Last updated
09/13/2019
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