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General NPI Number Information
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NPI Number | 1083202089
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Entity Type | Organization
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Legal Business Name | CHANGING PHASES SPEECH THERAPY
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 804 LANCASTER LN
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-8820
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Country | US
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Telephone | 757-898-0231
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Fax | 757-898-0231
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Provider Business Mailing Address
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Address Line | 804 LANCASTER LN
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-8820
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Country | US
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Telephone | 757-898-0231
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Fax |
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Authorized Official
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Title or Position | OWNER/ LEAD THERAPIST
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Name | MRS. NWAKEGO I THOMAS
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Credential | MA, CCC-SLP
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Telephone | 757-898-0231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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