=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023952132
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SEBRINA WHITED VAN HOY C-SLP-ASSISTANT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2026
-----------------------------------------------------
Last Update Date | 04/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2717 NC HIGHWAY 62 E
-----------------------------------------------------
City | LIBERTY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27298-9119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-685-5000
-----------------------------------------------------
Fax | 336-685-5006
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5203 FOLGERS MILL RD
-----------------------------------------------------
City | JULIAN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27283-9221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-685-5000
-----------------------------------------------------
Fax | 336-685-5006
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2355S0801X
-----------------------------------------------------
Taxonomy Name | Speech-Language Assistant
-----------------------------------------------------
License Number | 0911
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------