Provider Demographics
NPI:1871188698
Name:SUNRISE SPEECH AND SWALLOWING THERAPY PLLC
Entity Type:Organization
Organization Name:SUNRISE SPEECH AND SWALLOWING THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BJORLIE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:828-260-1277
Mailing Address - Street 1:323 NORTHEAST AVE
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2615
Mailing Address - Country:US
Mailing Address - Phone:828-260-1277
Mailing Address - Fax:828-581-4096
Practice Address - Street 1:323 NORTHEAST AVE
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-2615
Practice Address - Country:US
Practice Address - Phone:828-620-1277
Practice Address - Fax:828-581-4096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty