Provider Demographics
NPI:1063649739
Name:IT'S ABOUT TIME SPEECH & LANGUAGE SERVICES
Entity Type:Organization
Organization Name:IT'S ABOUT TIME SPEECH & LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:COBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC/SLP, PHD
Authorized Official - Phone:757-618-6621
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-0759
Mailing Address - Country:US
Mailing Address - Phone:757-618-6621
Mailing Address - Fax:
Practice Address - Street 1:135 HUNTING RIDGE RD APT 706
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4128
Practice Address - Country:US
Practice Address - Phone:757-618-6621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty