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NPI Code Detail

MEDICARE: SUNSHINE SPEECH THERAPY, INC.

MEDICARE: SUNSHINE SPEECH THERAPY, INC.
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
1235Z00000XSpeech-Language Pathologist7301NC
2235Z00000XSpeech-Language PathologistST.10813OH

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 : 1649400334
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNSHINE SPEECH THERAPY, INC.
Provider Business Mailing Address
First Line : 7091 TARRAGON CT
Second Line :
City : LIBERTY TWP
State : OH
Zip : 45011-9163
Country : US
Telephone Number : 910-297-9518
Fax Number : 910-399-5455
Provider Business Practice Location Address
First Line : 9443 COTTONWOOD LN SE
Second Line :
City : LELAND
State : NC
Zip : 28451-9545
Country : US
Telephone Number : 910-297-9518
Fax Number : 910-399-5455
Authorized Official
Title or Position : PRESIDENT, SPEECH-LANG PATHOLOGIST
Name : TANYA L. WESCOTT
Credential : M.A.,CCC-SLP
Telephone Number : 910-297-0518
Provider Enumeration Date : 07/16/2009
Last Update Date : 06/16/2014

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Directions to “SUNSHINE SPEECH THERAPY, INC. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.