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General NPI Number Information
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NPI Number | 1710313010
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Entity Type | Organization
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Legal Business Name | TINY TALKERS THERAPY SERVICES, INC.
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 960 DURHAM WAY
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7950
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Country | US
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Telephone | 404-395-4578
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Fax | 404-920-3396
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Provider Business Mailing Address
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Address Line | 960 DURHAM WAY
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7950
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Country | US
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Telephone | 404-395-4578
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Fax | 404-920-3396
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Authorized Official
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Title or Position | OWNER/SPEECH PATHOLOGIST
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Name | MRS. SHANNON TYLER
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Credential |
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Telephone | 404-395-4578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 004924
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License Number State | GA
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