Individual
SURYA STREATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
529 MONTGROVE PL NW, CONCORD, NC 28027-6554
(704) 779-5941
Mailing address
529 MONTGROVE PL NW, CONCORD, NC 28027-6554
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
6514
SC
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2355S0801X
MCKENZIE THERAPY CO
SC
01
—
6514
CONTRACTOR
SC
Enumeration date
03/13/2019
Last updated
03/13/2019
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