Provider Demographics
NPI:1093849341
Name:SPEECH DISCOVERY FOR KIDS, INC.
Entity Type:Organization
Organization Name:SPEECH DISCOVERY FOR KIDS, INC.
Other - Org Name:SPEECH DISCOVERY FOR KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, ADMINISTRATIOR AND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:REYNOLDS
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:704-896-8688
Mailing Address - Street 1:18047 W CATAWBA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5688
Mailing Address - Country:US
Mailing Address - Phone:704-896-8688
Mailing Address - Fax:704-896-7975
Practice Address - Street 1:18047 W CATAWBA AVE STE 203
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5688
Practice Address - Country:US
Practice Address - Phone:704-896-8688
Practice Address - Fax:704-896-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211771Medicaid
NC13936OtherBCBSNC
NC7412332Medicaid