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General NPI Number Information
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NPI Number | 1265121628
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Entity Type | Organization
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Legal Business Name | SIMPLY SPEECH, PLLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 2425 SURVEYOR GENERAL DR
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City | WAXHAW
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State | NC
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Zip | 28173-0073
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Country | US
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Telephone | 182-832-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 SURVEYOR GENERAL DR
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City | WAXHAW
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State | NC
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Zip | 28173-0073
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Country | US
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Telephone | 182-832-0035
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE CONKLING
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Credential | MS, CCC-SLP
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Telephone | 828-320-0359
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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 |
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License Number State |
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