Provider Demographics
NPI:1376053066
Name:VADLAMUDI, NEETHI PRIYA (MS (SLP))
Entity Type:Individual
Prefix:MRS
First Name:NEETHI
Middle Name:PRIYA
Last Name:VADLAMUDI
Suffix:
Gender:F
Credentials:MS (SLP)
Other - Prefix:
Other - First Name:NEETHI
Other - Middle Name:PRIYA
Other - Last Name:NARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2207 ROCKY BAY CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6690
Mailing Address - Country:US
Mailing Address - Phone:336-618-9681
Mailing Address - Fax:
Practice Address - Street 1:4201 LAKE BOONE TRL STE 4
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7511
Practice Address - Country:US
Practice Address - Phone:919-781-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1807161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty