Healthcare Provider Details

I. General information

NPI: 1245565126
Provider Name (Legal Business Name): CHAPEL HILL CHILDREN'S THERAPY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 HIGHLAND TRL
CHAPEL HILL NC
27516-8644
US

IV. Provider business mailing address

703 HIGHLAND TRL
CHAPEL HILL NC
27516-8644
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-4580
  • Fax: 919-968-4580
Mailing address:
  • Phone: 919-219-3014
  • Fax: 888-284-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4950
License Number StateNC

VIII. Authorized Official

Name: MS. HANNAH ELIZABETH FOUTS
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.ED., CCC-SLP
Phone: 919-219-3014