Healthcare Provider Details

I. General information

NPI: 1114844578
Provider Name (Legal Business Name): MIDTOWN SPEECH & LANGUAGE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
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: 910-338-9563
  • Fax:
Mailing address:
  • Phone: 910-338-9563
  • 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: DAISY JASMINE MEJIA
Title or Position: OWNER OR MANAGING MEMBER
Credential: M.S., CCC-SLP
Phone: 910-338-9563