Organization
BRANCH OUT NC, LLC
Active
Other names
Branch Out Speech Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
LENA R WEDEEN MS, CCC-SLP (MANAGER)
(561) 876-2047
Entity
Organization
Contact information
Practice address
1802 GUESS RD, DURHAM, NC 27705-3333
(561) 876-2047
Mailing address
1802 GUESS RD, DURHAM, NC 27705-3333
(561) 876-2047
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15066848
CAQH
NC
Enumeration date
10/27/2021
Last updated
10/27/2021
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