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General NPI Number Information
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NPI Number | 1316175375
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Entity Type | Organization
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Legal Business Name | LINGUISTIC IMPRESSIONS THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 2451 CUMBERLAND PKWY SE SUITE 3693
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City | ATLANTA
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State | GA
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Zip | 30339-6136
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Country | US
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Telephone | 404-915-2736
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Fax | 404-795-0840
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Provider Business Mailing Address
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Address Line | 2451 CUMBERLAND PKWY SE SUITE 3693
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City | ATLANTA
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State | GA
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Zip | 30339-6136
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Country | US
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Telephone | 404-915-2736
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Fax | 404-795-0840
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | ANGELA M JONES
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Credential |
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Telephone | 404-915-2736
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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 | SLP006095
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License Number State | GA
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