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NPI Code Detail

MEDICARE: PEDIATRIC THERAPLAY SPEECH SERVICES, INC.

MEDICARE: PEDIATRIC THERAPLAY SPEECH SERVICES, 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
1225XP0200XPediatric Occupational Therapist
22251P0200XPediatric Physical TherapistNC
3235Z00000XSpeech-Language Pathologist
4225X00000XOccupational Therapist
5252Y00000XEarly Intervention Provider AgencyNC

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 : 1942286372
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC THERAPLAY SPEECH SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 480462
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-5320
Country : US
Telephone Number : 704-258-1724
Fax Number : 704-598-3024
Provider Business Practice Location Address
First Line : 3403 LINDEN BERRY LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-1300
Country : US
Telephone Number : 704-258-1724
Fax Number : 704-598-3024
Authorized Official
Title or Position : PRESIDENT
Name : MRS. WENDY YOSHINO TEAL
Credential : CCC-SLP
Telephone Number : 704-258-1724
Provider Enumeration Date : 12/18/2005
Last Update Date : 12/09/2007

Similar Medicare Providers

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Practice Location Address:
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28269-1300
Practice Phone: 704-258-1724
Practice Fax: 704-598-3024
1114973559 — MRS. TARA MICHELE JACKSON MA, CCC-SLP
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1285790683 — MRS. CORTNEY STEELE WALKER OTRL
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28269-1300
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Practice Fax: 704-598-3024
1881751014 — MRS. MELVA G. MCINTYRE M.A.,CCC-SLP
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1831246495 — MISS KATHLEEN ANNE LANE CCC-SLP
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1154467371 — MRS. MICHELLE HUGHES COLLIS MS, CCC-SLP
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Practice Fax:

Directions to “PEDIATRIC THERAPLAY SPEECH SERVICES, INC. ” Practice Location

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