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General NPI Number Information
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NPI Number | 1841142775
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Entity Type | Organization
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Legal Business Name | SOUTHERN SPEECH THERAPY
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 5425 W HIGHWAY 166
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City | CARROLLTON
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State | GA
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Zip | 30117
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Country | US
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Telephone | 678-274-7392
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 W HIGHWAY 166
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City | CARROLLTON
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State | GA
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Zip | 30117
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Country | US
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Telephone | 678-274-7392
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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 | KERI FAISON
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Credential | M.ED., CCC-SLP
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Telephone | 678-274-7392
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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 |
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License Number State |
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