Provider Demographics
NPI:1386831998
Name:UNCG SPEECH AND HEARING PROGRAM
Entity Type:Organization
Organization Name:UNCG SPEECH AND HEARING PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MS, SLP-CCC
Authorized Official - Phone:336-217-5120
Mailing Address - Street 1:5900 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9704
Mailing Address - Country:US
Mailing Address - Phone:336-217-5120
Mailing Address - Fax:336-217-5127
Practice Address - Street 1:5900 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9704
Practice Address - Country:US
Practice Address - Phone:336-217-5120
Practice Address - Fax:336-217-5127
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF NORTH CAROLINA AT GREENSBORO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech