Provider Demographics
NPI:1952645723
Name:DIAL, FALINE (MS, SLP)
Entity Type:Individual
Prefix:
First Name:FALINE
Middle Name:
Last Name:DIAL
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 3442
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-3442
Mailing Address - Country:US
Mailing Address - Phone:910-521-1677
Mailing Address - Fax:910-521-1676
Practice Address - Street 1:812 CANDY PARK RD
Practice Address - Street 2:SUITE 7101A
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9129
Practice Address - Country:US
Practice Address - Phone:910-521-1677
Practice Address - Fax:910-521-1676
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412034Medicaid