Provider Demographics
NPI:1356572382
Name:THE SPEECH & LANGUAGE CORNER, PLLC
Entity type:Organization
Organization Name:THE SPEECH & LANGUAGE CORNER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:DIXON-THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC-SLP
Authorized Official - Phone:704-626-7277
Mailing Address - Street 1:11947 STRATFIELD PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-7325
Mailing Address - Country:US
Mailing Address - Phone:704-626-7277
Mailing Address - Fax:704-626-7277
Practice Address - Street 1:11947 STRATFIELD PLACE CIR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-7325
Practice Address - Country:US
Practice Address - Phone:704-969-3815
Practice Address - Fax:704-969-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-08
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7133235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412528Medicaid