Healthcare Provider Details

I. General information

NPI: 1205760121
Provider Name (Legal Business Name): ALAYNA CASSIDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 PRINCE AVE
ATHENS GA
30606-5908
US

IV. Provider business mailing address

740 PRINCE AVE
ATHENS GA
30606-5908
US

V. Phone/Fax

Practice location:
  • Phone: 706-920-0232
  • Fax: 706-932-0206
Mailing address:
  • Phone: 706-920-0232
  • Fax: 706-932-0206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPCET004481
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: