Healthcare Provider Details

I. General information

NPI: 1205761996
Provider Name (Legal Business Name): ATLANTA NEURO SPEECH & SWALLOWING REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 NORTHSIDE PKWY NW APT 299
ATLANTA GA
30327-5297
US

IV. Provider business mailing address

4445 NORTHSIDE PKWY NW APT 299
ATLANTA GA
30327-5297
US

V. Phone/Fax

Practice location:
  • Phone: 321-749-4241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAYLA SINGLETON
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 321-749-4241