Provider Demographics
NPI:1881734754
Name:MADUJIBEYA, BELINDA J (MSP,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:J
Last Name:MADUJIBEYA
Suffix:
Gender:F
Credentials:MSP,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 LISBURN CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5051
Mailing Address - Country:US
Mailing Address - Phone:919-332-1022
Mailing Address - Fax:888-972-9297
Practice Address - Street 1:500 BENSON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3947
Practice Address - Country:US
Practice Address - Phone:919-332-1022
Practice Address - Fax:888-972-9297
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2143235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC54449Medicaid