Provider Demographics
NPI:1659361210
Name:CENTER FOR SPEECH EXCELLENCE INC
Entity Type:Organization
Organization Name:CENTER FOR SPEECH EXCELLENCE INC
Other - Org Name:PAMELA H BASHOR CCC SLP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST PRESIDE
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BASHOR
Authorized Official - Suffix:
Authorized Official - Credentials:CCC SLP
Authorized Official - Phone:704-375-5231
Mailing Address - Street 1:320 LILLINGTON AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3130
Mailing Address - Country:US
Mailing Address - Phone:704-375-5231
Mailing Address - Fax:704-376-6259
Practice Address - Street 1:320 LILLINGTON AVE
Practice Address - Street 2:STE 202
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3130
Practice Address - Country:US
Practice Address - Phone:704-375-5231
Practice Address - Fax:704-376-6259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0264NOtherBCBS