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General NPI Number Information
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NPI Number | 1174956924
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Entity Type | Organization
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Legal Business Name | INFANT CONNECTIONS, LLC
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 1631 RICHWOOD DR NE
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City | ATLANTA
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State | GA
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Zip | 30319-3605
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Country | US
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Telephone | 678-386-4395
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Fax | 678-281-1796
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Provider Business Mailing Address
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Address Line | 1631 RICHWOOD DR NE
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City | ATLANTA
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State | GA
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Zip | 30319-3605
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Country | US
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Telephone | 678-386-4395
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Fax | 678-281-1796
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY JENNINGS
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Credential | PT, DPT
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Telephone | 678-386-4395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT004893
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP006507
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT009158
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License Number State | GA
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