Healthcare Provider Details

I. General information

NPI: 1750295135
Provider Name (Legal Business Name): GREER GALLENTINE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 RIVER GREEN PKWY STE 610
DULUTH GA
30096-8337
US

IV. Provider business mailing address

811 KIRK RD
DECATUR GA
30030-4530
US

V. Phone/Fax

Practice location:
  • Phone: 678-395-3269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPCET004674
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: