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General NPI Number Information
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NPI Number | 1972728889
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Entity Type | Organization
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Legal Business Name | KIDSPEECH, INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 545 OLD NORCROSS RD SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3389
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Country | US
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Telephone | 678-377-2833
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Fax | 678-377-2882
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Provider Business Mailing Address
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Address Line | 545 OLD NORCROSS RD SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3390
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Country | US
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Telephone | 678-377-2833
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Fax | 678-377-2882
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN HALL
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Credential | M.ED.,CCC-SLP
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Telephone | 678-377-2833
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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 | 931800
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License Number State | GA
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