Organization
SALLY RAY MILLER PIDGE
Active
Other names
Sally Pidge dba Achieve
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY RAY PIDGE MED CCC-SLP (OWNER THERAPIST)
(704) 708-8314
Entity
Organization
Contact information
Practice address
2301 CROWN POINT EXECUTIVE DR, SUITE E, CHARLOTTE, NC 28227-6725
(704) 708-8314
(704) 708-8315
Mailing address
2301 CROWN POINT EXECUTIVE DR, SUITE E, CHARLOTTE, NC 28227-6725
(704) 708-8314
(704) 708-8315
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4234
NC
235Z00000X
Speech-Language Pathologist
2583
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411122
—
NC
Enumeration date
11/01/2006
Last updated
10/11/2012
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