Provider Demographics
NPI:1356054340
Name:ENGAGE SPEECH LANGUAGE SERVICES, PLLC
Entity type:Organization
Organization Name:ENGAGE SPEECH LANGUAGE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLEGARDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-268-9167
Mailing Address - Street 1:2459 WILKINSON BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208
Mailing Address - Country:US
Mailing Address - Phone:704-268-9167
Mailing Address - Fax:
Practice Address - Street 1:2459 WILKINSON BLVD STE 310
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208
Practice Address - Country:US
Practice Address - Phone:704-268-9167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty