Organization
CAROLINA PEDIATRIC DYSPHAGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN D COMRIE M.S., CCC-SLP (OWNER)
(919) 877-9800
Entity
Organization
Contact information
Practice address
3714 BENSON DR, SUITE 100, RALEIGH, NC 27609-7384
(919) 877-9800
(919) 877-9408
Mailing address
3714 BENSON DR, SUITE 100, RALEIGH, NC 27609-7384
(919) 877-9800
(919) 877-9408
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2274
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0270V
BCBS
NC
05
—
7210602
—
NC
Enumeration date
10/19/2006
Last updated
08/22/2013
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