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General NPI Number Information
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NPI Number | 1891145454
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Entity Type | Organization
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Legal Business Name | MEREDITH WHITE SPEECH PATHOLOGY, INC
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 1955 CLIFF VALLEY WAY NE SUIT 245
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City | ATLANTA
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State | GA
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Zip | 30329-2476
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Country | US
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Telephone | 404-228-8558
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Fax |
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Provider Business Mailing Address
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Address Line | 1955 CLIFF VALLEY WAY NE SUIT 245
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City | ATLANTA
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State | GA
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Zip | 30329-2476
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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 | SLP
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Name | MRS. MEREDITH WHITE
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Credential | M.ED. CCC-SLP, COM
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Telephone | 404-228-8558
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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 | SLP008909
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License Number State | GA
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