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NPI 1326947565

NPI 1326947565 : SPEAK LIFE THERAPY SERVICES LLC : OCHLOCKNEE, GA

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General NPI Number Information
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    NPI Number           |    1326947565
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    Entity Type          |    Organization 
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    Legal Business Name  |    SPEAK LIFE THERAPY SERVICES LLC 
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Dates
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    Enumeration Date     |    11/03/2026
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    Last Update Date     |    11/03/2026
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Provider Practice Location Address
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    Address Line         |    22812 US HIGHWAY 19 N 
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    City                 |    OCHLOCKNEE
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    State                |    GA
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    Zip                  |    31773-1784
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    Country              |    US
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    Telephone            |    229-376-8807
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    22812 US HIGHWAY 19 N 
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    City                 |    OCHLOCKNEE
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    State                |    GA
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    Zip                  |    31773-1784
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    Country              |    US
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    Telephone            |    229-376-8807
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    Fax                  |    912-809-4955
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. EMILY BAILEY GOFF 
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    Credential           |    CCC-SLP
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    Telephone            |    229-376-8807
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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       |    
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    License Number State |    
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