Provider Demographics
NPI:1255658977
Name:JUST TALK SPEECH SERVICES, INC
Entity Type:Organization
Organization Name:JUST TALK SPEECH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TOSHA
Authorized Official - Middle Name:LAKARA
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC-SLP
Authorized Official - Phone:910-366-1922
Mailing Address - Street 1:4621 DUNCASTLE RD APT 3A
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1654
Mailing Address - Country:US
Mailing Address - Phone:910-366-1922
Mailing Address - Fax:
Practice Address - Street 1:4621 DUNCASTLE RD APT 3A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1654
Practice Address - Country:US
Practice Address - Phone:910-366-1922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5414235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty