MEDICARE: BEATRICE W PERRY MA CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	7502	NC

General Provider Information

NPI Number	:	1548738487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRICE W PERRY MA CCC-SLP

Provider Business Mailing Address
First Line	:	2105 LOWER LAKE RD
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-3435
Country	:	US
Telephone Number	:	919-621-5886
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 S WHITE ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-2920
Country	:	US
Telephone Number	:	984-289-3890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2018
Last Update Date	:	12/15/2025

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Directions to “ BEATRICE W PERRY MA CCC-SLP” Practice Location

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