Provider Demographics
NPI:1568054906
Name:VINSON, NATALIE LAUREN (MED CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:LAUREN
Last Name:VINSON
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SALEM TOWNE CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2311
Mailing Address - Country:US
Mailing Address - Phone:919-749-7767
Mailing Address - Fax:
Practice Address - Street 1:130 SALEM TOWNE CT
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2311
Practice Address - Country:US
Practice Address - Phone:919-749-7767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007921235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist