MEDICARE: ISPEAK THERAPY SERVICES 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	SLP006824	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871986653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISPEAK THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	1388 VILLAGE CREEK CIR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-3281
Country	:	US
Telephone Number	:	470-210-4301
Fax Number	:	888-975-4313

Provider Business Practice Location Address
First Line	:	1388 VILLAGE CREEK CIR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-3281
Country	:	US
Telephone Number	:	470-210-4301
Fax Number	:	888-975-4313

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MS. ALFREDA LYNN MCKENZIE
Credential	:	CCC-SLP
Telephone Number	:	470-210-4301

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	03/18/2015

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Directions to “ISPEAK THERAPY SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

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