Provider Demographics
NPI:1518090075
Name:ABSOLUTE SPEECH & LANGUAGE THERAPY INC.
Entity Type:Organization
Organization Name:ABSOLUTE SPEECH & LANGUAGE THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BIZUB
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:919-870-1280
Mailing Address - Street 1:186 WIND CHIME CT STE 104
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6486
Mailing Address - Country:US
Mailing Address - Phone:919-870-1280
Mailing Address - Fax:919-870-1285
Practice Address - Street 1:186 WIND CHIME CT STE 104
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6486
Practice Address - Country:US
Practice Address - Phone:919-870-1280
Practice Address - Fax:919-870-1285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7200514Medicaid