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NPI Code Detail

MEDICARE: IN HAE CHUNG SLP

MEDICARE:   IN HAE  CHUNG  SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP011908GA

General Provider Information

NPI Number : 1396482790
Entity Type Code : Individual
Provider Name (Legal Business Name) : IN HAE CHUNG SLP
Provider Business Mailing Address
First Line : 3121 HUNTINGTON PL
Second Line :
City : MILTON
State : GA
Zip : 30004-4621
Country : US
Telephone Number : 404-784-1252
Fax Number :
Provider Business Practice Location Address
First Line : 3121 HUNTINGTON PL
Second Line :
City : MILTON
State : GA
Zip : 30004-4621
Country : US
Telephone Number : 404-784-1252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2022
Last Update Date : 05/17/2022

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Directions to “ IN HAE CHUNG SLP” Practice Location

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