| Therapeutic Specialties Of North Carolina, Pllc | |
|
104 Market St Henderson NC 27537-3751 | |
| (252) 431-4418 | |
| (252) 572-2418 |
| Full Name | Therapeutic Specialties Of North Carolina, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 104 Market St, Henderson, North Carolina |
| Authorized Official Name and Position | Tammy S Juntunen (CO-OWNER) |
| Authorized Official Contact | 2524314418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Specialties Of North Carolina, Pllc 104 Market Street Henderson NC 27537 Ph: (252) 431-4418 | Therapeutic Specialties Of North Carolina, Pllc 104 Market St Henderson NC 27537-3751 Ph: (252) 431-4418 |
| NPI Number | 1720381395 |
|---|---|
| Provider Enumeration Date | 12/21/2010 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 4284074394 |
|---|---|
| Medicare Enrollment ID | O20240506003230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720381395 | NPI | - | NPPES |
| 6107348 | Medicaid | NC | |
| 6107074 | Medicaid | NC |
| Provider Name | Rhonda Rae Hollowell |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1134984016 PECOS PAC ID: 7315387438 Enrollment ID: I20240506003474 |
| Provider Name | Jonna Mason Hall |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1346821949 PECOS PAC ID: 5597107128 Enrollment ID: I20240528001647 |
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