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General NPI Number Information
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NPI Number | 1235506726
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Entity Type | Organization
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Legal Business Name | WIREGRASS THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 121 HIDDEN GLEN WAY
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-446-1425
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Fax | 334-647-6458
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Provider Business Mailing Address
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Address Line | 121 HIDDEN GLEN WAY
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-446-1425
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Fax | 334-647-6458
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Authorized Official
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Title or Position | OWNER/SPEECH THERAPIST
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Name | CARI ORGERON
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Credential | MS, CCC-SLP
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Telephone | 334-446-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 3251
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License Number State | AL
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