MEDICARE: AALIYAH EDWARDS 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
1	235Z00000X	Speech-Language Pathologist	SLP013880	GA

General Provider Information

NPI Number	:	1598634545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH EDWARDS SLP

Provider Business Mailing Address
First Line	:	813 ROCK HILL PKWY
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-3644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 ROCK HILL PKWY
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-3644
Country	:	US
Telephone Number	:	662-816-4615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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