| Organization Name: | COASTAL SPEECH CENTER INC |
| NPI Number: | 1033271127 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBRA O DICKERSON (SPEECH PATHOLOGIST) |
| Mailing Address: | 210 Liberty Hill Rd Lumberton |
| State: | NC US |
| Postal Code: | 283582442 |
| Phone Number: | 9102729056 |
| Fax Number: | 9102729057 |
| NPI Enumeration Date: | 12/14/2006 |
| NPI Last Update Date: | 07/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3553 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |