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General NPI Number Information
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NPI Number | 1821418963
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Entity Type | Organization
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Legal Business Name | CHATTY CHILDREN SPEECH THERAPY
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 709 WINESAP CT
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City | HAMPTON
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State | GA
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Zip | 30228-4928
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Country | US
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Telephone | 678-525-9169
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Fax |
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Provider Business Mailing Address
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Address Line | 709 WINESAP CT
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City | HAMPTON
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State | GA
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Zip | 30228-4928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | KAMICA BAKER
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Credential | M.S.ED.,CCC-SLP
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Telephone | 678-525-9169
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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 | SLP007608
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License Number State | GA
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