MEDICARE: SUNFLOWER SPEECH & MYO THERAPY, 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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1649134560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNFLOWER SPEECH & MYO THERAPY, PLLC

Provider Business Mailing Address
First Line	:	7410 EDENBRIDGE LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10720 SIKES PL STE 120
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-8142
Country	:	US
Telephone Number	:	704-445-6841
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA GOFF
Credential	:	SLP
Telephone Number	:	704-445-6841

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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