Organization
CAROLINA COMMUNICATION AND DYSPHAGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA WADE (OWNER/SLP)
(252) 578-8978
Entity
Organization
Contact information
Practice address
192 LONG FARM RD, GARYSBURG, NC 27831-9750
(252) 578-8978
(252) 541-2062
Mailing address
PO BOX 161, SCOTLAND NECK, NC 27874-0161
(252) 578-8978
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
05/09/2022
Last updated
09/11/2023
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