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Organization

JAESAN PC

Active
Other names
SpeechWorks Therapy Services
Organization subpart
No

Provider details

NPI number
Authorized official
KAI ANE JERRELL M.A., CCC-SLP (CEO/OWNER)
(980) 237-6226
Entity
Organization

Contact information

Practice address
3116 MILTON RD STE F, CHARLOTTE, NC 28215-5079
(980) 237-6226
(980) 237-6288
Mailing address
3116 MILTON RD STE F, CHARLOTTE, NC 28215-5079
(980) 237-6226
(980) 237-6288

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
5842
NC
235Z00000X
Speech-Language Pathologist
6278
NC
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7212056
NC
05
7411868
NC
Enumeration date
03/15/2007
Last updated
10/27/2021
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