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Organization

AMITY SPEECH THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER ANN SHELTON MS, CCC-SLP (OWNER/MEMBER)
(336) 963-0439
Entity
Organization

Contact information

Practice address
1030 FLATS AVE APT 302, MEBANE, NC 27302-9966
(336) 963-0439
Mailing address
PO BOX 333, EFLAND, NC 27243-0333
(336) 963-0439

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1902389117
NC
Enumeration date
07/10/2020
Last updated
07/10/2020
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