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General NPI Number Information
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NPI Number | 1194806562
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Entity Type | Organization
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Legal Business Name | NANCY DEMETER MCCALL
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 205 GLEN OAK DR
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City | GOLDSBORO
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State | NC
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Zip | 27534-1705
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Country | US
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Telephone | 919-734-1773
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Fax | 919-580-0023
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Provider Business Mailing Address
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Address Line | 205 GLEN OAK DR
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City | GOLDSBORO
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State | NC
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Zip | 27534-1705
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Country | US
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Telephone | 919-734-1773
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MRS. NANCY DEMETER MCCALL
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Credential | SLP
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Telephone | 919-734-1773
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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 | 1253
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License Number State | NC
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