Provider Demographics
NPI:1114659679
Name:SPEECH FROM THE HEART PLLC
Entity Type:Organization
Organization Name:SPEECH FROM THE HEART PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:MOXLEY
Authorized Official - Last Name:RECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:704-701-6035
Mailing Address - Street 1:6013 MONTICELLO DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8870
Mailing Address - Country:US
Mailing Address - Phone:704-701-6035
Mailing Address - Fax:
Practice Address - Street 1:6013 MONTICELLO DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8870
Practice Address - Country:US
Practice Address - Phone:704-701-6035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty