MEDICARE: MS. MANDY MARIE SINE MED CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP006879	GA

General Provider Information

NPI Number	:	1184863367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MANDY MARIE SINE MED CCC-SLP

Provider Business Mailing Address
First Line	:	2620 N BERKELEY LAKE RD NW
Second Line	:	APT 535
City	:	DULUTH
State	:	GA
Zip	:	30096-1448
Country	:	US
Telephone Number	:	678-362-1774
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 N BERKELEY LAKE RD NW
Second Line	:	APT 535
City	:	DULUTH
State	:	GA
Zip	:	30096-1448
Country	:	US
Telephone Number	:	678-362-1774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2009
Last Update Date	:	02/12/2009

Similar Medicare Providers

1487518239 — DANA MICHELLE VINES
Practice Location Address:

3548 TRACEY DR
DULUTH, GA
30096-3861

Practice Phone: 770-490-2652
Practice Fax:

1174783435 — AG FAMILY MEDICINE, PC
Practice Location Address:

3590 PEACHTREE INDUSTRIAL BLVD
DULUTH, GA
30096-4817

Practice Phone: 770-614-9799
Practice Fax: 770-614-9789

1124983259 — JENNIFER JOHNSON
Practice Location Address:

722 RIDGE BROOK TRL
DULUTH, GA
30096-6806

Practice Phone: 678-613-1436
Practice Fax:

1316800253 — SKY MEDICAL SUPPLY LLC
Practice Location Address:

3675 CRESTWOOD PKWY NW STE 400
DULUTH, GA
30096-5054

Practice Phone: 561-552-5556
Practice Fax:

1982568556 — PATRICK NUGENT
Practice Location Address:

3005 BRECKINRIDGE BLVD STE 230
DULUTH, GA
30096-4978

Practice Phone: 404-224-9346
Practice Fax:

1871457366 — SHTARA REDDEN RN
Practice Location Address:

723 BRADFORD CREEK TRL
DULUTH, GA
30096-1402

Practice Phone: 716-374-1880
Practice Fax:

Directions to “ MS. MANDY MARIE SINE MED CCC-SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.