Provider Demographics
NPI:1629581806
Name:WILMINGTON SPEECH ASSOCIATES PC
Entity Type:Organization
Organization Name:WILMINGTON SPEECH ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:910-232-4297
Mailing Address - Street 1:501 HITCH CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-4735
Mailing Address - Country:US
Mailing Address - Phone:910-232-4297
Mailing Address - Fax:
Practice Address - Street 1:2002 EASTWOOD RD STE 202
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7203
Practice Address - Country:US
Practice Address - Phone:910-239-9466
Practice Address - Fax:910-239-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty