Provider Demographics
NPI:1013670553
Name:SPEECH AND FEEDING HAVEN PLLC
Entity Type:Organization
Organization Name:SPEECH AND FEEDING HAVEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:704-491-9847
Mailing Address - Street 1:1235 EAST BLVD STE E
Mailing Address - Street 2:129
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5870
Mailing Address - Country:US
Mailing Address - Phone:704-665-7611
Mailing Address - Fax:704-973-7784
Practice Address - Street 1:1235 EAST BLVD STE E
Practice Address - Street 2:129
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5870
Practice Address - Country:US
Practice Address - Phone:704-665-7611
Practice Address - Fax:704-973-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty