MEDICARE: POPPY SPEECH LLC

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	:	1952265480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POPPY SPEECH LLC

Provider Business Mailing Address
First Line	:	5670 CLOUDS HARBOR TRAIL
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5670 CLOUDS HARBOR TRAIL
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012
Country	:	US
Telephone Number	:	336-407-0447
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND PRESIDENT
Name	:	KELLY SPOLORIC
Credential	:	M.S., CCC-SLP
Telephone Number	:	336-407-0447

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “POPPY SPEECH LLC ” Practice Location

Language	Start Address	Practice Location

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