Provider Demographics
NPI:1174415517
Name:SPEECH THERAPY SANTA CRUZ
Entity type:Organization
Organization Name:SPEECH THERAPY SANTA CRUZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABADIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-760-9590
Mailing Address - Street 1:1049 LEWIS CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4370
Mailing Address - Country:US
Mailing Address - Phone:602-760-9590
Mailing Address - Fax:
Practice Address - Street 1:1049 LEWIS CIR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4370
Practice Address - Country:US
Practice Address - Phone:602-760-9590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech