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Organization
THERACOMM SPEECH THERAPY SVCS
Active
Organization
THERACOMM SPEECH THERAPY SVCS
Active
Other names
Theracomm Speech Therapy Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA F ROGERS MS CCC SLP (OWNER)
(910) 482-4819
Entity
Organization
Contact information
Practice address
6204 LAKE TRAIL DRIVE, FAYETTEVILLE, NC 28304-0502
(910) 482-4819
(910) 482-0637
Mailing address
6204 LAKE TRAIL DRIVE, FAYETTEVILLE, NC 28304-0502
(910) 482-4819
(910) 482-0637
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1514
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72828
BLUE CROSS BCBS
NC
05
—
7411025
—
NC
Enumeration date
07/31/2006
Last updated
08/22/2020
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