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Organization

SOUTHEAST FAMILY SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE CALDWELL CCC/SLP (CLINICAL DIRECTOR/OWNER)
(919) 783-8846
Entity
Organization

Contact information

Practice address
3716 NATIONAL DRIVE, SUITE 124, RALEIGH, NC 27612-4863
(919) 783-8846
Mailing address
3716 NATIONAL DRIVE, SUITE 124, RALEIGH, NC 27612-4863
(919) 783-8846

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
01/24/2008
Last updated
01/24/2008
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