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General NPI Number Information
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NPI Number | 1265834642
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Entity Type | Organization
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Legal Business Name | ACADEMICALLY SPEAKING, LLC
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 4066 HAMMOCK TRCE
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City | ATLANTA
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State | GA
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Zip | 30349-8865
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Country | US
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Telephone | 678-281-1830
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Fax | 404-745-8893
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Provider Business Mailing Address
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Address Line | 3695 CASCADE RD SW STE F #2285
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City | ATLANTA
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State | GA
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Zip | 30331-2146
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Country | US
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Telephone | 678-281-1830
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Fax | 404-745-8893
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST & OWNER
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Name | DENA FARMER
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Credential | M.ED., CCC-SLP
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Telephone | 678-281-1830
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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 | SLP007874
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License Number State | GA
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