Provider Demographics
NPI:1588063283
Name:E AND M SPEECH THERAPY
Entity type:Organization
Organization Name:E AND M SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER AND ORAGNIZER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAVITS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:919-414-6615
Mailing Address - Street 1:681 BLACK ANGUS DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6838
Mailing Address - Country:US
Mailing Address - Phone:919-414-6615
Mailing Address - Fax:
Practice Address - Street 1:681 BLACK ANGUS DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6838
Practice Address - Country:US
Practice Address - Phone:919-414-6615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1184913618OtherINDIVIDUAL NPI
NC7413529Medicaid