Organization
GOLD STAR PEDIATRIC SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANESSIA SHEPARD CCC-SLP (SPEECH PATHOLOGIST)
(336) 587-6902
Entity
Organization
Contact information
Practice address
283 ASHPOLE TRL, CLAYTON, NC 27520-1774
(336) 587-6902
Mailing address
283 ASHPOLE TRL, CLAYTON, NC 27520-1774
(336) 587-6902
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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