Individual
JEANIE FRYE LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
463 LENTZ RD, STATESVILLE, NC 28625-1596
(704) 682-4421
Mailing address
463 LENTZ RD, STATESVILLE, NC 28625-1596
(704) 682-4421
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6455
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136X5
BCBS NC
NC
05
—
7412131
—
NC
Enumeration date
06/09/2005
Last updated
08/12/2016
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