Provider Demographics
NPI:1548097181
Name:BRAVO SPEECH STUDIO
Entity type:Organization
Organization Name:BRAVO SPEECH STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-367-6497
Mailing Address - Street 1:14643 DOMART AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3442
Mailing Address - Country:US
Mailing Address - Phone:626-488-3091
Mailing Address - Fax:
Practice Address - Street 1:14643 DOMART AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3442
Practice Address - Country:US
Practice Address - Phone:626-488-3091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty