Organization
LASTING IMPACT SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAVERRA JONES CLINSCD, CCC-SLP (OWNER)
(803) 543-9988
Entity
Organization
Contact information
Practice address
8627 MINERAL RIDGE WAY, CHARLOTTE, NC 28269-6148
(803) 543-9988
Mailing address
8627 MINERAL RIDGE WAY, CHARLOTTE, NC 28269-6148
(803) 543-9988
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/05/2020
Last updated
01/05/2020
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