Provider Demographics
NPI:1255619508
Name:EASTERN NORTH CAROLINA SCHOOL FOR THE DEAF
Entity type:Organization
Organization Name:EASTERN NORTH CAROLINA SCHOOL FOR THE DEAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERBEEK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:252-237-2450
Mailing Address - Street 1:1311 US 301 SOUTH
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-6621
Mailing Address - Country:US
Mailing Address - Phone:252-237-2450
Mailing Address - Fax:252-265-4576
Practice Address - Street 1:1311 US 301 SOUTH
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-6621
Practice Address - Country:US
Practice Address - Phone:252-237-2450
Practice Address - Fax:252-265-4576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC298251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)