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Organization

PEDIATRIC SPEECH LANGUAGE THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. REBECCA SOLDAN BROADFOOT MA,CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(252) 339-8145
Entity
Organization

Contact information

Practice address
1216 CRESCENT DR, ELIZABETH CITY, NC 27909-6652
(252) 339-8145
(252) 338-9156
Mailing address
1216 CRESCENT DR, ELIZABETH CITY, NC 27909-6652
(252) 339-8145
(252) 338-9156

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
11106
NC

Other

Enumeration date
11/04/2014
Last updated
11/04/2014
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