Provider Demographics
NPI:1659833275
Name:CRECER SPEECH AND LANGUAGE THERAPY, PLLC
Entity Type:Organization
Organization Name:CRECER SPEECH AND LANGUAGE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:LILIAN
Authorized Official - Last Name:SEGOVIA
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:336-675-4598
Mailing Address - Street 1:4030 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-9739
Mailing Address - Country:US
Mailing Address - Phone:336-675-4598
Mailing Address - Fax:
Practice Address - Street 1:4030 SOUTHVIEW DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-9739
Practice Address - Country:US
Practice Address - Phone:336-675-4598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty