Healthcare Provider Details

I. General information

NPI: 1992068076
Provider Name (Legal Business Name): ENETTA DENYSE STRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 STATE ROAD 1632
ROCKY POINT NC
28457
US

IV. Provider business mailing address

5100 HEADING BLUFF RD
CURRIE NC
28435-5316
US

V. Phone/Fax

Practice location:
  • Phone: 910-658-2831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9479
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: