Healthcare Provider Details

I. General information

NPI: 1134749336
Provider Name (Legal Business Name): SIMPLICITY THERAPY GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 ACADEMY ST STE 102
CANTON GA
30114-3008
US

IV. Provider business mailing address

PO BOX 1901
ROSWELL GA
30077-1901
US

V. Phone/Fax

Practice location:
  • Phone: 404-444-1521
  • Fax: 404-689-4209
Mailing address:
  • Phone: 404-897-8960
  • Fax: 404-689-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ALEC MICHAEL MARTINO
Title or Position: MANAGER
Credential:
Phone: 404-897-8960