Provider Demographics
NPI:1285140590
Name:COASTAL SPEECH THERAPY SOLUTIONS, PLLC
Entity type:Organization
Organization Name:COASTAL SPEECH THERAPY SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-331-3467
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:HOBBSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27946-0130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:166 JOPPA RD
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NC
Practice Address - Zip Code:27919
Practice Address - Country:US
Practice Address - Phone:252-325-8810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty