Healthcare Provider Details

I. General information

NPI: 1790332948
Provider Name (Legal Business Name): ACR SPEAKING DIMENSIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 COOPER RD STE 100
GRAYSON GA
30017-4268
US

IV. Provider business mailing address

315 WILD BARLEY WAY
LOGANVILLE GA
30052-7845
US

V. Phone/Fax

Practice location:
  • Phone: 478-804-2070
  • Fax:
Mailing address:
  • Phone: 478-804-2070
  • 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: MRS. ANDREA DAVIDSON
Title or Position: CEO/SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 478-804-2070