Basic Information
| Provider Information | |||||||||
| NPI: | 1518161900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAILEY | ||||||||
| FirstName: | ROSCHELLE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4216 PLANTERS WATCH DR | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282780040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042995569 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5700 EXECUTIVE CENTER DR | ||||||||
| Address2: | SUITE110 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282128858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045666040 | ||||||||
| FaxNumber: | 7045259337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 7067 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.