Healthcare Provider Details

I. General information

NPI: 1972425130
Provider Name (Legal Business Name): FUNCTIONAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 VANCE ST NW
LENOIR NC
28645-4136
US

IV. Provider business mailing address

3731 HARTLAND RD
MORGANTON NC
28655-8533
US

V. Phone/Fax

Practice location:
  • Phone: 828-302-7370
  • Fax:
Mailing address:
  • Phone: 828-302-7370
  • 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: KAYLA DAWN REICHARD
Title or Position: OWNER/EMPLOYEE
Credential: M.S. CCC-SLP
Phone: 828-302-7370