=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205799269
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPEAK EASY WITH BRANDY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2025
-----------------------------------------------------
Last Update Date | 12/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8735 DUNWOODY PL STE 7945
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30350-2995
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-548-3290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8735 DUNWOODY PL STE 7945
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30350-2995
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-548-3290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MRS. BRANDY MAK
-----------------------------------------------------
Credential | M.S.
-----------------------------------------------------
Telephone | 929-548-3290
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------