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Organization

GIRASOL PEDIATRIC SPEECH THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERICA NICOLE WILLIAMS (SPEECH LANGUAGE PATHOLOGIST)
(919) 824-2393
Entity
Organization

Contact information

Practice address
102 SHADOW HAWK DR, DURHAM, NC 27713-3157
(919) 824-2393
Mailing address
102 SHADOW HAWK DR, DURHAM, NC 27713-3157
(919) 824-2393

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1386900736
NC
Enumeration date
03/29/2021
Last updated
03/29/2021
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