Healthcare Provider Details

I. General information

NPI: 1932024544
Provider Name (Legal Business Name): SYDNEY BEATTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 GA-332
HOSCHTON GA
30548
US

IV. Provider business mailing address

1730 GUM SPRINGS CHURCH RD
JEFFERSON GA
30549-4432
US

V. Phone/Fax

Practice location:
  • Phone: 706-654-5013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: