Organization
PATHWAYS 2 SPEECH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ELIZABETH CLEMONS M.A. (LSLS CERT. AVT, CCC-SLP)
(760) 518-8563
Entity
Organization
Contact information
Practice address
719 FRANKLIN LN, VISTA, CA 92084-5153
(760) 518-8563
(760) 480-7366
Mailing address
719 FRANKLIN LN, VISTA, CA 92084-5153
(760) 518-8563
(760) 480-7366
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
CERT. AVT 1031201020
CA
235Z00000X
Speech-Language Pathologist
SP9784
CA
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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