Provider Demographics
NPI:1508160854
Name:SPEAK & PLAY
Entity Type:Organization
Organization Name:SPEAK & PLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JASMIN
Authorized Official - Last Name:SWEPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:910-599-7812
Mailing Address - Street 1:3941B MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1403
Mailing Address - Country:US
Mailing Address - Phone:910-599-7812
Mailing Address - Fax:910-202-6477
Practice Address - Street 1:3941B MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1403
Practice Address - Country:US
Practice Address - Phone:910-599-7812
Practice Address - Fax:910-202-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty