Provider Demographics
NPI:1114410396
Name:CONNECT SPEECH AND LANGUAGE SERVICES PLLC
Entity Type:Organization
Organization Name:CONNECT SPEECH AND LANGUAGE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:BRUNDAGE
Authorized Official - Last Name:LERCH
Authorized Official - Suffix:
Authorized Official - Credentials:SLP - CCC
Authorized Official - Phone:910-619-6115
Mailing Address - Street 1:1473 BIG LEAF LOOP
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9018
Mailing Address - Country:US
Mailing Address - Phone:919-521-0369
Mailing Address - Fax:
Practice Address - Street 1:1473 BIG LEAF LOOP
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9018
Practice Address - Country:US
Practice Address - Phone:919-521-0369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty