Organization
INNOVATE SPEECH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE TAWANNA (OWNER)
(949) 418-7167
Entity
Organization
Contact information
Practice address
17870 SKY PARK CIR STE 105, IRVINE, CA 92614-6449
(949) 418-7167
Mailing address
17870 SKY PARK CIR STE 105, IRVINE, CA 92614-6449
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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