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Organization

CAPITOL CITY SPEECH THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY BARNES (OWNER/MANAGER)
(919) 577-6807
Entity
Organization

Contact information

Practice address
141 N MAIN ST, FUQUAY VARINA, NC 27526-1933
(919) 577-6807
Mailing address
141 N MAIN ST, FUQUAY VARINA, NC 27526-1933
(919) 577-6807

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
4178
NC
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300172
NC
Enumeration date
09/23/2007
Last updated
07/02/2013
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