Provider Demographics
NPI:1386074219
Name:BLD SPEECH AND ASSOCIATES
Entity type:Organization
Organization Name:BLD SPEECH AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH & LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:917-309-3179
Mailing Address - Street 1:4601 MINERAL SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8814
Mailing Address - Country:US
Mailing Address - Phone:917-309-3179
Mailing Address - Fax:888-908-8745
Practice Address - Street 1:4601 MINERAL SPRINGS LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-8814
Practice Address - Country:US
Practice Address - Phone:917-309-3179
Practice Address - Fax:888-908-8745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9430252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency