Organization
GATEWAY PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDI THOMAS MA, CCC-SLP (MANAGING PARTNER/SLP)
(919) 578-8096
Entity
Organization
Contact information
Practice address
501 GATEWAY DR, SUITE 101 E, CLAYTON, NC 27520-2277
(919) 578-8096
(844) 407-5282
Mailing address
1348 ILEAGNES RD, RALEIGH, NC 27603-3436
(407) 619-7082
(844) 407-5282
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10547
NC
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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