Provider Demographics
NPI:1487821302
Name:SOUTHERN THERAPY SERVICES
Entity type:Organization
Organization Name:SOUTHERN THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:910-638-1939
Mailing Address - Street 1:79 N SHAMROCK DR
Mailing Address - Street 2:
Mailing Address - City:FOXFIRE VILLAGE
Mailing Address - State:NC
Mailing Address - Zip Code:27281-9706
Mailing Address - Country:US
Mailing Address - Phone:910-638-1939
Mailing Address - Fax:
Practice Address - Street 1:79 N SHAMROCK DR
Practice Address - Street 2:
Practice Address - City:FOXFIRE VILLAGE
Practice Address - State:NC
Practice Address - Zip Code:27281-9706
Practice Address - Country:US
Practice Address - Phone:910-638-1939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty