Healthcare Provider Details

I. General information

NPI: 1891611216
Provider Name (Legal Business Name): THE SPEECH AND LANGUAGE THERAPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 THORNTON RD STE U
LITHIA SPRINGS GA
30122-1558
US

IV. Provider business mailing address

4421 DENTON DR
DOUGLASVILLE GA
30135-3373
US

V. Phone/Fax

Practice location:
  • Phone: 404-729-9725
  • Fax:
Mailing address:
  • Phone:
  • 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: TINEKA THOMPSON
Title or Position: OWNER
Credential:
Phone: 404-729-9725