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General NPI Number Information
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NPI Number | 1871986653
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Entity Type | Organization
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Legal Business Name | ISPEAK THERAPY SERVICES LLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 1388 VILLAGE CREEK CIR SE
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City | ATLANTA
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State | GA
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Zip | 30316-3281
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Country | US
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Telephone | 470-210-4301
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Fax | 888-975-4313
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Provider Business Mailing Address
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Address Line | 1388 VILLAGE CREEK CIR SE
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City | ATLANTA
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State | GA
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Zip | 30316-3281
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Country | US
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Telephone | 470-210-4301
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Fax | 888-975-4313
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MS. ALFREDA LYNN MCKENZIE
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Credential | CCC-SLP
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Telephone | 470-210-4301
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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 | SLP006824
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License Number State | GA
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