Healthcare Provider Details

I. General information

NPI: 1437083094
Provider Name (Legal Business Name): FORWARD SPEECH AND LANGUAGE THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 LAKE BOONE TRL STE 2D
RALEIGH NC
27607-7503
US

IV. Provider business mailing address

4601 LAKE BOONE TRL STE 2D
RALEIGH NC
27607-7503
US

V. Phone/Fax

Practice location:
  • Phone: 734-476-0255
  • 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: CLARICE FRIEDRICH
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 734-476-0255