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NPI Code Detail

MEDICARE: SPEECH&LANGUAGE FOUNDATION PLLC

MEDICARE: SPEECH&LANGUAGE FOUNDATION PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist
2252Y00000XEarly Intervention Provider Agency
3235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407977747
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEECH&LANGUAGE FOUNDATION PLLC
Provider Business Mailing Address
First Line : PO BOX 26034
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28314-5017
Country : US
Telephone Number : 910-488-4100
Fax Number : 910-483-8721
Provider Business Practice Location Address
First Line : 5330 RAEFORD RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3074
Country : US
Telephone Number : 910-488-4100
Fax Number : 910-483-8721
Authorized Official
Title or Position : OWNER
Name : MRS. SONYA EVANS OATES
Credential : MSCCC-SLP
Telephone Number : 910-488-7309
Provider Enumeration Date : 04/03/2007
Last Update Date : 10/14/2014

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Directions to “SPEECH&LANGUAGE FOUNDATION PLLC ” Practice Location

Language Start Address Practice Location
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