| Life 360 Therapy Services, Inc | |
|
13721 Heritage Dr, Laurinburg, NC 28352-9185 | |
| (910) 206-8228 | |
| Not Available |
| Full Name | Life 360 Therapy Services, Inc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 13721 Heritage Dr, Laurinburg, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508238403 | NPI | - | NPPES |
| 1285893354 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 7173 (North Carolina) | Primary |
| Provider Name | Rebecca Russell |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1285893354 PECOS PAC ID: 4183023682 Enrollment ID: I20210603002671 |
| Mailing Address | Practice Location Address |
|---|---|
| Life 360 Therapy Services, Inc 13721 Heritage Dr, Laurinburg, NC 28352-9185 Ph: (910) 206-8228 | Life 360 Therapy Services, Inc 13721 Heritage Dr, Laurinburg, NC 28352-9185 Ph: (910) 206-8228 |
Ms. Melody K Stills, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 714 Atkinson Street, Laurinburg, NC 28352 Phone: 910-423-5622 Fax: 910-423-5538 | |
Kierstin Brooks Godfrey, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 704b Progress Pl, Laurinburg, NC 28352 Phone: 910-217-1862 Fax: 910-506-4076 | |
Carolina Therapy Associates, Llc Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 303 West Boulevard, Laurinburg, NC 28352 Phone: 910-506-4810 | |
Rebecca Amber Crowe Russell, M.S. , CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 13721 Heritage Dr, Laurinburg, NC 28352 Phone: 910-206-8228 | |
Kali M Deese, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 714 Atkinson St, Laurinburg, NC 28352 Phone: 910-277-1588 Fax: 910-277-1589 | |
Mrs. Katherine Covington Bullard, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 416 S King St, Laurinburg, NC 28352 Phone: 910-276-3313 | |
Robin Davis, M.ED., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 714 Atkinson St, Laurinburg, NC 28352 Phone: 910-277-1588 Fax: 910-277-1589 |