Healthcare Provider Details

I. General information

NPI: 1679401772
Provider Name (Legal Business Name): CORAPEAKE SPEECH & SWALLOW SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 UNION BRANCH RD
CORAPEAKE NC
27926-9627
US

IV. Provider business mailing address

660 UNION BRANCH RD
CORAPEAKE NC
27926-9627
US

V. Phone/Fax

Practice location:
  • Phone: 734-644-6697
  • Fax:
Mailing address:
  • Phone: 734-644-6697
  • 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: JARI JANIS BILLIOT
Title or Position: PRESIDENT/CEO
Credential: CCC-SLP
Phone: 734-644-6697