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Organization
SPEAK 1ST CAROLINA
Active
Organization
SPEAK 1ST CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUSAN POWELL (MANAGER)
(919) 219-7404
Entity
Organization
Contact information
Practice address
701 W TRINITY AVE APT 108, DURHAM, NC 27701-1869
(919) 219-3053
Mailing address
1025 VALLEY ROSE WAY, DURHAM, NC 27712-2991
(919) 219-3053
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7413310
—
NC
Enumeration date
03/19/2015
Last updated
04/02/2019
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