Provider Demographics
NPI:1588010755
Name:PLAY AND SAY SPEECH THERAPY, PC
Entity Type:Organization
Organization Name:PLAY AND SAY SPEECH THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:COFFEY
Authorized Official - Last Name:CYPHER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:910-520-7973
Mailing Address - Street 1:224 COLQUITT DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-3175
Mailing Address - Country:US
Mailing Address - Phone:910-520-7973
Mailing Address - Fax:910-338-2260
Practice Address - Street 1:224 COLQUITT DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-3175
Practice Address - Country:US
Practice Address - Phone:910-520-7973
Practice Address - Fax:910-338-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1093850497Medicaid
NC1093850497OtherBCBSNC
NC6530OtherSTATE BOARD OF EXAMINER'S FOR SLP'S