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General NPI Number Information
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NPI Number | 1265245807
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Entity Type | Organization
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Legal Business Name | GOLDEN LOTUS THERAPY LLC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 837 LEGENDS DR
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City | MONTGOMERY
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State | AL
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Zip | 36116-6575
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Country | US
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Telephone | 334-625-1512
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 WHITE CLOUD DR
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City | DEATSVILLE
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State | AL
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Zip | 36022-2570
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Country | US
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Telephone | 334-625-1512
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | JA'KECIA HOWARD
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Credential | M.S.,CCC-SLP
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Telephone | 334-625-1512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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