Provider Demographics
NPI:1134981160
Name:SPEECH SPAN
Entity type:Organization
Organization Name:SPEECH SPAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL-GILES
Authorized Official - Suffix:
Authorized Official - Credentials:CLINSCD, CCC-SLP
Authorized Official - Phone:704-748-2140
Mailing Address - Street 1:202 LITHIA INN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4217
Mailing Address - Country:US
Mailing Address - Phone:704-748-2140
Mailing Address - Fax:702-748-2142
Practice Address - Street 1:202 LITHIA INN RD
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4217
Practice Address - Country:US
Practice Address - Phone:704-748-2140
Practice Address - Fax:702-748-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty