Provider Demographics
NPI:1861033086
Name:NEXT GENERATION PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:NEXT GENERATION PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:919-633-0081
Mailing Address - Street 1:1717 VENEZIA WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4737
Mailing Address - Country:US
Mailing Address - Phone:919-633-0081
Mailing Address - Fax:
Practice Address - Street 1:1717 VENEZIA WAY
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4737
Practice Address - Country:US
Practice Address - Phone:919-633-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty