Organization
LAND PEDIATRIC SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANIA L.B. LAND CCC-SLP (OWNER)
(336) 202-7604
Entity
Organization
Contact information
Practice address
4108 CASCADE DR, GREENSBORO, NC 27410-3910
(336) 202-7604
(336) 852-9342
Mailing address
4108 CASCADE DR, GREENSBORO, NC 27410-3910
(336) 202-7604
(336) 852-9342
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4424
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411443
—
NC
Enumeration date
04/16/2013
Last updated
04/16/2013
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