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Organization

DOGWOOD DEVELOPMENTAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACY E WILSON M.S. (CCC-SLP)
(910) 824-4394
Entity
Organization

Contact information

Practice address
16525 US HIGHWAY 17 N, #D, HAMPSTEAD, NC 28443-7440
(910) 824-4394
Mailing address
441 MCPHEE DR, FAYETTEVILLE, NC 28305-5129
(910) 824-4394

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8028
NC

Other

Enumeration date
09/10/2016
Last updated
01/27/2017
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