Healthcare Provider Details

I. General information

NPI: 1609739390
Provider Name (Legal Business Name): TALK TREE SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5077 DALLAS HWY STE 105
POWDER SPRINGS GA
30127-4510
US

IV. Provider business mailing address

5077 DALLAS HWY STE 105
POWDER SPRINGS GA
30127-4510
US

V. Phone/Fax

Practice location:
  • Phone: 862-395-5247
  • Fax: 862-395-5247
Mailing address:
  • Phone: 862-395-5247
  • Fax: 862-395-5247

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: LORETHA WILSON
Title or Position: OWNER
Credential:
Phone: 862-395-5247