Provider Demographics
NPI:1851171326
Name:CONNECT KIDS THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:CONNECT KIDS THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HARWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:336-870-0551
Mailing Address - Street 1:4997 LEIGH LN
Mailing Address - Street 2:
Mailing Address - City:SOPHIA
Mailing Address - State:NC
Mailing Address - Zip Code:27350-9030
Mailing Address - Country:US
Mailing Address - Phone:336-870-0551
Mailing Address - Fax:
Practice Address - Street 1:4997 LEIGH LN
Practice Address - Street 2:
Practice Address - City:SOPHIA
Practice Address - State:NC
Practice Address - Zip Code:27350-9030
Practice Address - Country:US
Practice Address - Phone:336-870-0551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty