Healthcare Provider Details

I. General information

NPI: 1790860740
Provider Name (Legal Business Name): SPEECH AND READING THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10020 CLOISTERS CLUB LN #107
CHARLOTTE NC
28278-7592
US

IV. Provider business mailing address

10020 CLOISTERS CLUB LN #107
CHARLOTTE NC
28278-7592
US

V. Phone/Fax

Practice location:
  • Phone: 919-827-2763
  • Fax:
Mailing address:
  • Phone: 919-827-2763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number5676
License Number StateNC

VIII. Authorized Official

Name: DR. MONICA WEATHERS
Title or Position: PRESIDEN
Credential: PHD
Phone: 919-827-2763