Provider Demographics
NPI:1114172483
Name:OVERFLOW ENTERPRISES, INC.
Entity Type:Organization
Organization Name:OVERFLOW ENTERPRISES, INC.
Other - Org Name:THE READING ROOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:SHIVAUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:910-737-6300
Mailing Address - Street 1:209 RENTON CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-3414
Mailing Address - Country:US
Mailing Address - Phone:910-737-6300
Mailing Address - Fax:910-737-6333
Practice Address - Street 1:3101 FAYETTEVILLE RD STE E
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2775
Practice Address - Country:US
Practice Address - Phone:910-737-6300
Practice Address - Fax:910-737-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty