MEDICARE: MS. HEATHER LEIGH HAMILTON M.S., 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	SLP007896	GA

General Provider Information

NPI Number	:	1396096368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER LEIGH HAMILTON M.S., CCC-SLP

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
Second Line	:	SUITE 680
City	:	ATLANTA
State	:	GA
Zip	:	30324-3015
Country	:	US
Telephone Number	:	813-300-8819
Fax Number	:

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

Provider Enumeration Date	:	09/30/2012
Last Update Date	:	03/31/2015

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