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NPI Code Detail

MEDICARE: SYDNEY DELISSA BASSARD CCC-SLP

MEDICARE: SYDNEY DELISSA BASSARD CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2202009747VA
2235Z00000XSpeech-Language Pathologist14593NC

General Provider Information

NPI Number : 1770254096
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY DELISSA BASSARD CCC-SLP
Provider Business Mailing Address
First Line : 6911 SHANNON WILLOW RD STE 700
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-1353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6911 SHANNON WILLOW RD STE 700
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-1353
Country : US
Telephone Number : 704-540-3777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2021
Last Update Date : 12/15/2021

Similar Medicare Providers

1447944160 — CHRISTINE ELIZABETH CAMERON MS CCC-SLP
Practice Location Address:
6911 SHANNON WILLOW RD STE 700
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Practice Fax:
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1194249367 — LAUREN VICTORIA VASQUEZ M.S. CCC SLP
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1447899026 — MOLLY ELIZABETH BROWN
Practice Location Address:
6911 SHANNON WILLOW RD STE 700
CHARLOTTE, NC
28226-1353
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Practice Fax:
1366171746 — MS. JULIA GRANATO MA CF-SLP
Practice Location Address:
6911 SHANNON WILLOW RD STE 700
CHARLOTTE, NC
28226-1353
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Practice Fax:
1720783095 — MEGHAN KEOHANE
Practice Location Address:
6911 SHANNON WILLOW RD STE 700
CHARLOTTE, NC
28226-1353
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Practice Fax:

Directions to “ SYDNEY DELISSA BASSARD CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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