Provider Demographics
NPI:1588937809
Name:THERAPLAY SPEECH & LANGUAGE SERVICES, PLLC
Entity type:Organization
Organization Name:THERAPLAY SPEECH & LANGUAGE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:LIPPITT
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:910-612-2814
Mailing Address - Street 1:122 BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1110
Mailing Address - Country:US
Mailing Address - Phone:910-612-2814
Mailing Address - Fax:910-341-7908
Practice Address - Street 1:122 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1110
Practice Address - Country:US
Practice Address - Phone:910-612-2814
Practice Address - Fax:910-341-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411502Medicaid