Provider Demographics
NPI:1770223778
Name:QUILLING, BETSY ROSS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:ROSS
Last Name:QUILLING
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 N REILLY RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2499
Mailing Address - Country:US
Mailing Address - Phone:910-920-2661
Mailing Address - Fax:910-920-2660
Practice Address - Street 1:576 N REILLY RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-2499
Practice Address - Country:US
Practice Address - Phone:910-920-2661
Practice Address - Fax:910-920-2660
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15006235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist