Organization
EDPATH SPECIALIZED LEARNING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL GRACE (OWNER-DIRECTOR)
(336) 705-1763
Entity
Organization
Contact information
Practice address
180 THACKER RD, RURAL HALL, NC 27045-9629
(336) 705-1763
Mailing address
180 THACKER RD, RURAL HALL, NC 27045-9629
(336) 705-1763
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
WSCDSA-0716
NC
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
07/15/2016
Last updated
11/24/2021
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