Organization
CAROLINA SPEECH SOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN DONOVAN (OWNER)
(828) 322-7826
Entity
Organization
Contact information
Practice address
858 2ND ST NE STE 101, HICKORY, NC 28601-3878
(828) 322-7826
Mailing address
858 2ND ST NE STE 101, HICKORY, NC 28601-3878
(828) 322-7826
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211073
—
NC
Enumeration date
12/27/2005
Last updated
02/18/2020
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