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Organization
PEDIATRIC THERAPEUTIC COACHING
Active
Organization
PEDIATRIC THERAPEUTIC COACHING
Active
Other names
Pediatric Therapeutic Coaching
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M WALTERS MA CCC SLP (SPEECH/LANGUAGE PATHOLOGIST)
(704) 787-0224
Entity
Organization
Contact information
Practice address
1301 ROLLING HILLS CT, CONCORD, NC 28025-9148
(704) 787-0224
Mailing address
1171 MARKET ST, FORT MILL, SC 29708-6500
(704) 787-0224
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5556
SC
235Z00000X
Speech-Language Pathologist
7056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346204708
NPI
NC
Enumeration date
12/01/2014
Last updated
12/01/2014
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