Provider Demographics
NPI:1205319571
Name:PLAY TO LEARN SPEECH AND LANGUAGE SERVICES, PLLC
Entity type:Organization
Organization Name:PLAY TO LEARN SPEECH AND LANGUAGE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:919-302-6491
Mailing Address - Street 1:4804 SINCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5450
Mailing Address - Country:US
Mailing Address - Phone:919-302-6491
Mailing Address - Fax:
Practice Address - Street 1:4804 SINCLAIR DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5450
Practice Address - Country:US
Practice Address - Phone:919-302-6491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty