Provider Demographics
NPI:1831774793
Name:DYSPHAGIA AND VOICE THERAPEUTICS PLLC
Entity type:Organization
Organization Name:DYSPHAGIA AND VOICE THERAPEUTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:910-217-1862
Mailing Address - Street 1:PO BOX 2183
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-2183
Mailing Address - Country:US
Mailing Address - Phone:910-217-1862
Mailing Address - Fax:
Practice Address - Street 1:2600 ST ANNA RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8420
Practice Address - Country:US
Practice Address - Phone:910-217-1862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty