Organization
CENTER FOR SPEECH & LANGUAGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHILA RUSSELL M.S., CCC-SLP (OWNER)
(209) 827-1500
Entity
Organization
Contact information
Practice address
312 W J ST, SUITE 202, LOS BANOS, CA 93635-4073
(209) 827-1500
(209) 827-1300
Mailing address
312 W J ST, SUITE 202, LOS BANOS, CA 93635-4073
(209) 827-1500
(209) 827-1300
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14526
CA
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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