Provider Demographics
NPI:1649646365
Name:SPEECHNOW
Entity type:Organization
Organization Name:SPEECHNOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:PETERSON
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:910-547-3782
Mailing Address - Street 1:313 BLUEBEECH LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-0526
Mailing Address - Country:US
Mailing Address - Phone:910-547-3782
Mailing Address - Fax:
Practice Address - Street 1:313 BLUEBEECH LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-0526
Practice Address - Country:US
Practice Address - Phone:910-547-3782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5291261QA3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA3000XAmbulatory Health Care FacilitiesClinic/CenterAugmentative Communication