Organization
CAROLINA SPEECH SOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN DONOVAN (OWNER)
(828) 781-7826
Entity
Organization
Contact information
Practice address
118 5TH AVE NW, HICKORY, NC 28601-4929
(828) 322-7826
Mailing address
118 5TH AVE NW, HICKORY, NC 28601-4929
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300167K
—
NC
Enumeration date
01/31/2007
Last updated
12/07/2018
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