Provider Demographics
NPI:1508801127
Name:TRIANGLE SPEECH SERVICES
Entity Type:Organization
Organization Name:TRIANGLE SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC
Authorized Official - Phone:919-489-5464
Mailing Address - Street 1:5500 FORTUNES RIDGE DR
Mailing Address - Street 2:UNIT 74C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9365
Mailing Address - Country:US
Mailing Address - Phone:919-489-5464
Mailing Address - Fax:919-489-5464
Practice Address - Street 1:5500 FORTUNES RIDGE DR
Practice Address - Street 2:UNIT 74C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9365
Practice Address - Country:US
Practice Address - Phone:919-489-5464
Practice Address - Fax:919-489-5464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty