Healthcare Provider Details

I. General information

NPI: 1447691993
Provider Name (Legal Business Name): NORTH PAULDING SPEECH LANGUAGE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 RED HAWK WAY
DALLAS GA
30132-1149
US

IV. Provider business mailing address

283 RED HAWK WAY
DALLAS GA
30132-1149
US

V. Phone/Fax

Practice location:
  • Phone: 561-801-3148
  • Fax: 678-401-6655
Mailing address:
  • Phone: 561-801-3148
  • Fax: 678-401-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP007396
License Number StateGA

VIII. Authorized Official

Name: MRS. LAURA LEIGH KNOTT-RIGGALL
Title or Position: OWNER, SPEECH LANGUAGE PATHOLOGIST
Credential: M.A., CCC-SLP
Phone: 561-801-3148