Provider Demographics
NPI:1104402015
Name:STORYTIME SPEECH THERAPY, PLLC
Entity type:Organization
Organization Name:STORYTIME SPEECH THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:ADELE
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:910-420-0449
Mailing Address - Street 1:114 LAKE ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-5402
Mailing Address - Country:US
Mailing Address - Phone:910-200-4494
Mailing Address - Fax:
Practice Address - Street 1:114 LAKE ARTHUR DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NC
Practice Address - Zip Code:28570-5402
Practice Address - Country:US
Practice Address - Phone:910-200-4494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech