Provider Demographics
NPI:1497713473
Name:SPEECH PLAY, INC.
Entity Type:Organization
Organization Name:SPEECH PLAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCCSLP
Authorized Official - Phone:252-443-0407
Mailing Address - Street 1:2024 JOELENE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1533
Mailing Address - Country:US
Mailing Address - Phone:252-443-0407
Mailing Address - Fax:252-443-6851
Practice Address - Street 1:2024 JOELENE DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-1533
Practice Address - Country:US
Practice Address - Phone:252-443-0407
Practice Address - Fax:252-443-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3540235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1003WOtherBCBS OF NC
NC7211269Medicaid