Provider Demographics
NPI:1508337379
Name:NEUSE RIVER SPEECH AND LANGUAGE THERAPY PLLC
Entity Type:Organization
Organization Name:NEUSE RIVER SPEECH AND LANGUAGE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GRIESBAUER
Authorized Official - Last Name:SHERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-640-7180
Mailing Address - Street 1:205 MAGNOLIA CIR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-8875
Mailing Address - Country:US
Mailing Address - Phone:252-640-7180
Mailing Address - Fax:919-763-1328
Practice Address - Street 1:205 MAGNOLIA CIR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-8875
Practice Address - Country:US
Practice Address - Phone:252-640-7180
Practice Address - Fax:919-763-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty