Doctor Name: | MRS. MARTHA R. EANES |
NPI Number: | 1942496625 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., CCC-SLP |
License Number: | 5260 |
Business Practice Address: | 3117 Lodge Dr Jamestown, NC - 272828535 |
Business Phone Number: | 3362929277 |
Business Fax Number: | 3362921292 |
Mailing Address: | 3117 Lodge Dr, JAMESTOWN |
State: | NC |
Postal Code: | 272828535 |
Phone Number: | 3362929277 |
Fax Number: | 3362921292 |
NPI Enumeration Date: | 09/17/2007 |
NPI Last Update Date: | 09/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5260 |
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 |