Provider Demographics
NPI:1508837808
Name:COMRIE, JOAN D (SLP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:D
Last Name:COMRIE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 BENSON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7384
Mailing Address - Country:US
Mailing Address - Phone:919-877-9800
Mailing Address - Fax:919-877-9408
Practice Address - Street 1:3714 BENSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7384
Practice Address - Country:US
Practice Address - Phone:919-877-9800
Practice Address - Fax:919-877-9408
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0270VOtherBCBS
NC7210602Medicaid