Organization Name: | PEDIATRIC PROMISE THERAPY SPECIALISTS, INC |
NPI Number: | 1073943585 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEIGH MEGAN JUSTICE (PRESIDENT/OWNER) |
Mailing Address: | 1523 Anthem Ct Charlotte |
State: | NC US |
Postal Code: | 282057980 |
Phone Number: | 7045599010 |
Fax Number: | 7049007383 |
NPI Enumeration Date: | 11/19/2013 |
NPI Last Update Date: | 11/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9066 |
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 |