Provider Demographics
NPI:1063770352
Name:BJM SPEECH LANGUAGE THERAPY & REHABILITATION SERVICES, INC.
Entity type:Organization
Organization Name:BJM SPEECH LANGUAGE THERAPY & REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MADUJIBEYA
Authorized Official - Suffix:
Authorized Official - Credentials:MSP
Authorized Official - Phone:919-662-0456
Mailing Address - Street 1:401 AVERSBORO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-3633
Mailing Address - Country:US
Mailing Address - Phone:919-332-1022
Mailing Address - Fax:888-972-9297
Practice Address - Street 1:401 AVERSBORO RD STE 200
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3633
Practice Address - Country:US
Practice Address - Phone:919-332-1022
Practice Address - Fax:888-972-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2143235Z00000X, 261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty