| Organization Name: | EASTERN WAKE SPEECH THERAPY, LLC |
| NPI Number: | 1497094536 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA COTTLE KAPL (SPEECH/LANGUAGE PATHOLOGIST) |
| Mailing Address: | 3221 Buckhill Trl Zebulon |
| State: | NC US |
| Postal Code: | 275979605 |
| Phone Number: | 9199093577 |
| Fax Number: | 9193754469 |
| NPI Enumeration Date: | 02/09/2013 |
| NPI Last Update Date: | 02/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 6369 |
| 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 |