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NPI Code Detail

MEDICARE: MANOR OF SPEAKING, LLC

MEDICARE: MANOR OF SPEAKING, 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
1261QH0700XHearing and Speech Clinic/CenterSLP006018GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21205012911OTHERGAINDIVIDUAL NPI

General Provider Information

NPI Number : 1932432168
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANOR OF SPEAKING, LLC
Provider Business Mailing Address
First Line : 511 W FORSYTH ST
Second Line : SUITE E
City : AMERICUS
State : GA
Zip : 31709-3465
Country : US
Telephone Number : 229-928-8202
Fax Number : 229-928-8205
Provider Business Practice Location Address
First Line : 511 W FORSYTH ST
Second Line : SUITE E
City : AMERICUS
State : GA
Zip : 31709-3465
Country : US
Telephone Number : 229-928-8202
Fax Number : 229-928-8205
Authorized Official
Title or Position : SPEECH-LANGUAGE PATHOLOGIST
Name : MRS. COURTNEY EDMUNDS JACOBS
Credential : CCC
Telephone Number : 229-928-8202
Provider Enumeration Date : 09/04/2009
Last Update Date : 09/09/2009

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Directions to “MANOR OF SPEAKING, LLC ” Practice Location

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