Provider Demographics
NPI:1891976288
Name:CAROLINA SPEECH SERVICES, INC.
Entity type:Organization
Organization Name:CAROLINA SPEECH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:770-490-2747
Mailing Address - Street 1:132 LAKEHILL DR.
Mailing Address - Street 2:
Mailing Address - City:FAIR PLAY
Mailing Address - State:SC
Mailing Address - Zip Code:29643-2516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 LAKEHILL DR.
Practice Address - Street 2:
Practice Address - City:FAIR PLAY
Practice Address - State:SC
Practice Address - Zip Code:29643-2516
Practice Address - Country:US
Practice Address - Phone:770-490-2747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4213261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720146459OtherNPI