Organization
KIDSPEAK SPEECH AND LANGUAGE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDY ROGERS M.S., CCC-SLP (OWNER)
(917) 628-7525
Entity
Organization
Contact information
Practice address
6911 SHANNON WILLOW ROAD, SUITE 700, CHARLOTTE, NC 28226
(704) 540-3777
(704) 540-1443
Mailing address
6911 SHANNON WILLOW ROAD, SUITE 700, CHARLOTTE, NC 28226
(704) 540-3777
(704) 540-1443
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4765
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12889
BLUECROSSBLUESHIELD
NC
01
—
7648723
AETNA
NC
Enumeration date
02/27/2007
Last updated
02/20/2024
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