Healthcare Provider Details

I. General information

NPI: 1720452212
Provider Name (Legal Business Name): SPEECH CONNECTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DOWD CIR SUITE A
PINEHURST NC
28374-7901
US

IV. Provider business mailing address

5 DOWD CIR SUITE A
PINEHURST NC
28374-7901
US

V. Phone/Fax

Practice location:
  • Phone: 910-690-4033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2013-0013
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KENDRA EARWOOD
Title or Position: MANAGER
Credential:
Phone: 910-690-4033