Organization
INTERSEED N GROW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY DUNSTON CHANCELLOR M.ED. (DEVELOPMENTAL THERAPIST)
(919) 478-9974
Entity
Organization
Contact information
Practice address
10704 DEBMOOR PL, RALEIGH, NC 27614-7018
(919) 478-9974
Mailing address
PO BOX 97051, RALEIGH, NC 27624-7051
(919) 478-9974
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
02/12/2015
Last updated
08/13/2021
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