Olive Branch Speech and Language Services, PC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10823 Issued in NC

Legal business name

OLIVE BRANCH SPEECH AND LANGUAGE SERVICES, PC

Practice address

115 Amberleigh Dr Apt 301
Wilmington, NC 28411-9846

Phone

(910) 899-2585

Fax

(910) 401-1555

NPI assigned

Jul 10, 2015

Last updated

Jul 10, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nancy Laurice, M.S. CCC/SLP-CI

Title

Owner/ Speech Language Pathologist

Phone

(910) 899-2585

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1659755528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 AMBERLEIGH DR APT 301",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119846",
            "telephone_number": "910-899-2585",
            "fax_number": "910-401-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 AMBERLEIGH DR APT 301",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119846",
            "telephone_number": "910-899-2585",
            "fax_number": "910-401-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH SPEECH AND LANGUAGE SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "LAURICE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OWNER/ SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "910-899-2585",
        "authorized_official_credential": "M.S. CCC/SLP-CI"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.