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General NPI Number Information
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NPI Number | 1205462645
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Entity Type | Organization
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Legal Business Name | BE THE CHANGE THERAPY, LLC
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 31 N MAIN ST
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2064
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Country | US
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Telephone | 706-363-0161
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 HARDIGREE BELL RD
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City | BISHOP
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State | GA
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Zip | 30621-1451
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/SLP
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Name | RACHEL GARRETT
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Credential | M.ED., CCC-SLP
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Telephone | 706-363-0161
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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 |
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License Number State |
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