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General NPI Number Information
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NPI Number | 1538464797
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Entity Type | Organization
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Legal Business Name | DISCOVER SPEECH LLC
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 6624 SAINT ABERNATHY DR SE
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City | MABLETON
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State | GA
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Zip | 30126-6409
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Country | US
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Telephone | 404-808-5770
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Fax |
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Provider Business Mailing Address
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Address Line | 6624 SAINT ABERNATHY DR SE
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City | MABLETON
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State | GA
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Zip | 30126-6409
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Country | US
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Telephone | 404-808-5770
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Fax |
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Authorized Official
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Title or Position | CEO/SPEECH THERAPIST
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Name | MRS. ADINA BRADSHAW
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Credential | MS CCC-SLP
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Telephone | 404-808-5770
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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 | SLP005864
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License Number State | GA
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