Healthcare Provider Details

I. General information

NPI: 1609797992
Provider Name (Legal Business Name): LAURELL ANNETTE DAYE SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 VILLAGE CENTER PKWY STE 190
STOCKBRIDGE GA
30281-6396
US

IV. Provider business mailing address

393 MICA TRL
RIVERDALE GA
30296-6004
US

V. Phone/Fax

Practice location:
  • Phone: 404-723-5583
  • Fax:
Mailing address:
  • Phone: 770-316-7510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP004152
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: