MEDICARE: TALK SPEECH & LANGUAGE THERAPY, LLC

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	SLP007896	GA

General Provider Information

NPI Number	:	1366950388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALK SPEECH & LANGUAGE THERAPY, LLC

Provider Business Mailing Address
First Line	:	1218 N DECATUR RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-2308
Country	:	US
Telephone Number	:	813-300-8819
Fax Number	:

Provider Business Practice Location Address
First Line	:	690 MIAMI CIR NE STE 680
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3015
Country	:	US
Telephone Number	:	770-302-6902
Fax Number	:	770-302-6902

Authorized Official
Title or Position	:	OWNER
Name	:	HEATHER LEIGH HAMILTON
Credential	:	CCC-SLP
Telephone Number	:	813-300-8819

Provider Enumeration Date	:	01/11/2018
Last Update Date	:	01/11/2018

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Directions to “TALK SPEECH & LANGUAGE THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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