Organization
KIDCOM, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA MARIE POPE CCC-SLP (PRESIDENT)
(919) 550-2457
Entity
Organization
Contact information
Practice address
865 CARLTON ST, CLAYTON, NC 27520-3716
(919) 550-2457
(919) 585-4603
Mailing address
865 CARLTON ST, CLAYTON, NC 27520-3716
(919) 550-2457
(919) 585-4603
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
09144065
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411774
—
NC
Enumeration date
01/21/2007
Last updated
08/22/2020
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