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General NPI Number Information
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NPI Number | 1730722935
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Entity Type | Individual
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Provider Name | ROSE OMEIRE SLP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2019
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 130 TRINITY AVE SW
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City | ATLANTA
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State | GA
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Zip | 30303-3626
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Country | US
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Telephone | 404-802-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 2875 CRESCENT PKWY APT 1323
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City | ATLANTA
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State | GA
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Zip | 30339-6278
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Country | US
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Telephone | 832-416-1170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 113876
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License Number State | GA
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