Organization
COASTAL SPEECH AND LANGUAGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANDIE TITO M.S., CCC-SLP (ORGANIZER)
(910) 367-8208
Entity
Organization
Contact information
Practice address
5006 CARLETON DR UNIT 13, WILMINGTON, NC 28403-7412
(910) 367-8208
(877) 750-3858
Mailing address
5006 CARLETON DR UNIT 13, WILMINGTON, NC 28403-7412
(910) 367-8208
(877) 750-3858
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8096
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7413459
—
NC
Enumeration date
06/29/2011
Last updated
06/29/2011
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