MEDICARE: RAVEN GUNN LLC

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

General Provider Information

NPI Number	:	1831031830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAVEN GUNN LLC

Provider Business Mailing Address
First Line	:	249 HARBOR POINTE DR
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30087-6176
Country	:	US
Telephone Number	:	404-219-2909
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 HARBOR POINTE DR
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30087-6176
Country	:	US
Telephone Number	:	404-219-2909
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MS. RAVEN NICOLE GUNN
Credential	:	M.S. CCC-SLP
Telephone Number	:	404-219-2909

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “RAVEN GUNN LLC ” Practice Location

Language	Start Address	Practice Location

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