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General NPI Number Information
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NPI Number | 1407552177
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Entity Type | Organization
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Legal Business Name | RESTORATIVE LANGUAGE THERAPY SERVICES
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 300 BRIDGEWATER LN
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City | DARIEN
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State | GA
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Zip | 31305-3179
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Country | US
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Telephone | 912-248-2734
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Fax |
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Provider Business Mailing Address
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Address Line | 300 BRIDGEWATER LN
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City | DARIEN
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State | GA
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Zip | 31305-3179
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Country | US
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Telephone | 912-248-2734
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | JANINE KREIDER
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Credential | CCC-SLP
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Telephone | 912-248-2734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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