Organization
PEDIATRIC THERAPLAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY TEAL (SLP)
(704) 258-1724
Entity
Organization
Contact information
Practice address
3214 NODA BLVD, CHARLOTTE, NC 28205-1259
(829) 773-3038
Mailing address
3214 NODA BLVD, CHARLOTTE, NC 28205-1259
(829) 773-3038
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
8042
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7412950
—
NC
Enumeration date
11/29/2012
Last updated
11/29/2012
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