Healthcare Provider Details

I. General information

NPI: 1083014948
Provider Name (Legal Business Name): DAISY JASMINE MEJIA CFY-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 FORDHAM RD
WILMINGTON NC
28403-7115
US

IV. Provider business mailing address

1901 FORDHAM RD
WILMINGTON NC
28403-7115
US

V. Phone/Fax

Practice location:
  • Phone: 914-233-4572
  • Fax:
Mailing address:
  • Phone: 914-233-4572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15051812
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: