Provider Demographics
NPI:1295365948
Name:TORBERT, BUFFY MONTGOMERY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BUFFY
Middle Name:MONTGOMERY
Last Name:TORBERT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10007 SUNSET RIDGE COURT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28107
Mailing Address - Country:US
Mailing Address - Phone:334-201-6719
Mailing Address - Fax:
Practice Address - Street 1:1411 DOVE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5014
Practice Address - Country:US
Practice Address - Phone:704-993-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist