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General NPI Number Information
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NPI Number | 1306026497
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Entity Type | Organization
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Legal Business Name | THE SPEECH & SWALLOWING CLINIC, LLC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 618 BOWENS MILL RD SW
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City | DOUGLAS
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State | GA
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Zip | 31533-3926
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Country | US
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Telephone | 912-331-0846
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Fax | 678-792-4894
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Provider Business Mailing Address
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Address Line | 118 PEARL AVE N
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City | DOUGLAS
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State | GA
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Zip | 31533-4632
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Country | US
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Telephone | 912-331-0846
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Fax | 678-792-4894
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MRS. MISTY BROWN
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Credential |
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Telephone | 912-331-0846
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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 | 004462
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License Number State | GA
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