Healthcare Provider Details

I. General information

NPI: 1659440329
Provider Name (Legal Business Name): RAND SPEECH PATHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 N DECATUR RD UNIT 506
DECATUR GA
30033-5305
US

IV. Provider business mailing address

2107 N DECATUR RD UNIT 506
DECATUR GA
30033-5305
US

V. Phone/Fax

Practice location:
  • Phone: 678-429-3790
  • Fax: 678-254-1778
Mailing address:
  • Phone: 678-429-3790
  • Fax: 404-929-6683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA RAND
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential:
Phone: 678-429-3790