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Organization
SPEECH MASTERS THERAPY SERVICES
Active
Organization
SPEECH MASTERS THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY JACKSON M.ED., CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(919) 821-1822
Entity
Organization
Contact information
Practice address
100 MONIE LN, RALEIGH, NC 27601-1560
(919) 821-1822
(919) 821-7779
Mailing address
100 MONIE LN, RALEIGH, NC 27601-1560
(919) 821-1822
(919) 821-7779
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130AT
BCBSGROUP PROVIDER NUMBER
NC
05
—
7210822
—
NC
Enumeration date
05/19/2006
Last updated
07/21/2022
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