Provider Demographics
NPI:1669583720
Name:ALPHA & OMEGA SPEECH THERAPY CONSULTANTS, PLLC
Entity type:Organization
Organization Name:ALPHA & OMEGA SPEECH THERAPY CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLEY-COX
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:828-248-1214
Mailing Address - Street 1:509 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-6108
Mailing Address - Country:US
Mailing Address - Phone:828-248-1214
Mailing Address - Fax:828-247-8828
Practice Address - Street 1:509 BUTLER RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-6108
Practice Address - Country:US
Practice Address - Phone:828-248-1214
Practice Address - Fax:828-247-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5989235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7212030Medicaid