Provider Demographics
NPI:1154867208
Name:SPEECH PROS PLLC
Entity Type:Organization
Organization Name:SPEECH PROS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:919-413-8030
Mailing Address - Street 1:629 CONVEXA CT
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-6504
Mailing Address - Country:US
Mailing Address - Phone:919-413-8030
Mailing Address - Fax:
Practice Address - Street 1:629 CONVEXA CT
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-6504
Practice Address - Country:US
Practice Address - Phone:919-413-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7683235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty