Provider Demographics
NPI:1861215279
Name:COMPLETE SPEECH THERAPY AND WELLNESS PLLC
Entity type:Organization
Organization Name:COMPLETE SPEECH THERAPY AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:
Authorized Official - First Name:LAKEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-517-5841
Mailing Address - Street 1:3800 COTTAGE PATH
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29153-7559
Mailing Address - Country:US
Mailing Address - Phone:704-681-1110
Mailing Address - Fax:
Practice Address - Street 1:800 BRIAR CREEK RD STE AA206
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7147
Practice Address - Country:US
Practice Address - Phone:705-681-1110
Practice Address - Fax:704-749-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty