Provider Demographics
NPI:1598366114
Name:SISTERS IN SPEECH, PC
Entity Type:Organization
Organization Name:SISTERS IN SPEECH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:GRAHAM
Authorized Official - Last Name:GRAHAM YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-316-8665
Mailing Address - Street 1:66 PEWEE LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-8069
Mailing Address - Country:US
Mailing Address - Phone:828-316-8665
Mailing Address - Fax:
Practice Address - Street 1:66 PEWEE LN
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-8069
Practice Address - Country:US
Practice Address - Phone:828-316-8665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10315OtherNORTH CAROLINA BOAR OF EXAMINERS SPEECH LANGUAGE PATHOLOGIST AND AUDIOLOGY
NC12096OtherNORTH CAROLINA BOARD OF EXAMINERS OF SPEECH LANGUAGE PATHOLOGIST AND AUDIOLOGY