Organization
ITHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW GUGGEMOS M.S., CCC-SLP (CEO)
(707) 656-3688
Entity
Organization
Contact information
Practice address
649 MAIN ST # 229, MARTINEZ, CA 94553-1137
(707) 656-3688
Mailing address
649 MAIN STREET #229, MARTINEZ, CA 94553
(707) 656-3688
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
252Y00000X
Early Intervention Provider Agency
—
CA
Other
Enumeration date
03/02/2016
Last updated
07/21/2022
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