Provider Demographics
NPI:1891192340
Name:ADVANCED BILINGUAL THERAPIES
Entity type:Organization
Organization Name:ADVANCED BILINGUAL THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATAKI
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:919-423-9885
Mailing Address - Street 1:600 N GREGSON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1703
Mailing Address - Country:US
Mailing Address - Phone:919-423-9885
Mailing Address - Fax:888-688-4045
Practice Address - Street 1:600 N GREGSON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1703
Practice Address - Country:US
Practice Address - Phone:919-423-9885
Practice Address - Fax:888-688-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9243235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty