Provider Demographics
NPI:1093284572
Name:TRIANGLE SPEECH AND LANGUAGE SERVICES
Entity Type:Organization
Organization Name:TRIANGLE SPEECH AND LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:GUSTIN
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:919-302-7291
Mailing Address - Street 1:124 SWEET VIOLET DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9804
Mailing Address - Country:US
Mailing Address - Phone:919-302-7291
Mailing Address - Fax:
Practice Address - Street 1:124 SWEET VIOLET DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9804
Practice Address - Country:US
Practice Address - Phone:919-302-7291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty