Provider Demographics
NPI:1962746644
Name:SPEECH N PROGRESS, INC.
Entity type:Organization
Organization Name:SPEECH N PROGRESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FALINE
Authorized Official - Middle Name:LOCKLEAR
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC/SLP
Authorized Official - Phone:910-521-1677
Mailing Address - Street 1:PO BOX 3442
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-3442
Mailing Address - Country:US
Mailing Address - Phone:910-521-1677
Mailing Address - Fax:910-521-1676
Practice Address - Street 1:812 CANDY PARK RD
Practice Address - Street 2:SUITE 7101 A
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9129
Practice Address - Country:US
Practice Address - Phone:910-521-1677
Practice Address - Fax:910-521-1676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7200540Medicaid