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General NPI Number Information
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NPI Number | 1104176718
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Entity Type | Organization
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Legal Business Name | A TO Z PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 5825 GLENRIDGE DR NE BLDG 1, SUITE 133
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City | ATLANTA
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State | GA
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Zip | 30328-5387
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Country | US
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Telephone | 678-733-9318
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Fax | 404-902-5440
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Provider Business Mailing Address
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Address Line | 5825 GLENRIDGE DR NE BLDG 1, SUITE 133
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City | ATLANTA
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State | GA
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Zip | 30328-5387
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Country | US
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Telephone | 678-733-9318
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Fax | 404-902-5440
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | AMANDA ZITO
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Credential | M.S., CCC-SLP
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Telephone | 678-733-9318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP005916
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License Number State | GA
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