Healthcare Provider Details

I. General information

NPI: 1881229250
Provider Name (Legal Business Name): WOOD SLP SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 CONIFER WAY
SHELBY NC
28150-7302
US

IV. Provider business mailing address

270 CONIFER WAY
SHELBY NC
28150-7302
US

V. Phone/Fax

Practice location:
  • Phone: 704-473-1675
  • Fax:
Mailing address:
  • Phone: 704-473-1675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SHANA WOOD PRICE
Title or Position: PRESIDENT
Credential: MS, CCC-SLP
Phone: 704-473-1675