Provider Demographics
NPI:1265121628
Name:SIMPLY SPEECH, PLLC
Entity type:Organization
Organization Name:SIMPLY SPEECH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONKLING
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:828-320-0359
Mailing Address - Street 1:2425 SURVEYOR GENERAL DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-0073
Mailing Address - Country:US
Mailing Address - Phone:182-832-0035
Mailing Address - Fax:
Practice Address - Street 1:2425 SURVEYOR GENERAL DR
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-0073
Practice Address - Country:US
Practice Address - Phone:182-832-0035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech