# SPEECH MASTERS THERAPY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548214125
- **Authorized official:** MRS. TIFFANY JACKSON M.ED., CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (919) 821-1822

## Contact information

- **Practice address:** 100 MONIE LN, RALEIGH, NC 27601-1560
- **Practice address phone:** (919) 821-1822
- **Practice address fax:** (919) 821-7779
- **Mailing address:** 100 MONIE LN, RALEIGH, NC 27601-1560
- **Mailing address phone:** (919) 821-1822
- **Mailing address fax:** (919) 821-7779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | NC | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 130AT | BCBSGROUP PROVIDER NUMBER | NC |
| 05 | — | 7210822 | — | NC |