Organization
AMERICAN RIVER SPEECH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANE DEGELLEKE (OWNER)
(916) 631-0428
Entity
Organization
Contact information
Practice address
11344 COLOMA RD, GOLD RIVER, CA 95670-4457
(916) 631-0428
Mailing address
11344 COLOMA RD, GOLD RIVER, CA 95670-4457
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SP 16930
CA
235Z00000X
Speech-Language Pathologist
Primary
SP 3598
CA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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