Organization
SPEECH FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA DARICE CENOVA MS, CCC-SLP (OWNER/CLINICIAN)
(503) 501-8566
Entity
Organization
Contact information
Practice address
6107 SW MURRAY BLVD # 323, BEAVERTON, OR 97008-4421
(503) 501-8566
Mailing address
6107 SW MURRAY BLVD # 323, BEAVERTON, OR 97008-4421
(503) 501-8566
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11955
OR
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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