Provider Demographics
NPI:1992087274
Name:SIMPLY THERAPY, P.C.
Entity type:Organization
Organization Name:SIMPLY THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:N. AMALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:336-462-7911
Mailing Address - Street 1:3455 POLO RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-4859
Mailing Address - Country:US
Mailing Address - Phone:336-462-7911
Mailing Address - Fax:336-768-1860
Practice Address - Street 1:3455 POLO RD
Practice Address - Street 2:SUITE 109
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-4859
Practice Address - Country:US
Practice Address - Phone:336-462-7911
Practice Address - Fax:336-768-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty