Healthcare Provider Details

I. General information

NPI: 1649134560
Provider Name (Legal Business Name): SUNFLOWER SPEECH & MYO THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10720 SIKES PL STE 120
CHARLOTTE NC
28277-8142
US

IV. Provider business mailing address

7410 EDENBRIDGE LN
CHARLOTTE NC
28226-3392
US

V. Phone/Fax

Practice location:
  • Phone: 704-445-6841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA GOFF
Title or Position: OWNER
Credential: SLP
Phone: 704-445-6841