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General NPI Number Information
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NPI Number | 1972233484
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Entity Type | Organization
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Legal Business Name | CLINICAL SPEECH THERAPY PLLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 511 S 5TH ST
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City | SANFORD
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State | NC
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Zip | 27330-4910
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Country | US
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Telephone | 919-353-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 511 S 5TH ST
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City | SANFORD
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State | NC
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Zip | 27330-4910
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Country | US
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Telephone | 919-353-1212
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Fax |
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Authorized Official
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Title or Position | MEMBER AND ORGANIZER
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Name | INMACULADA SIMANCAS MARTIN
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Credential | MS, CCC-SLP
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Telephone | 919-353-1212
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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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