MEDICARE: TALK TREE SPEECH 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

General Provider Information

NPI Number	:	1609739390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALK TREE SPEECH THERAPY LLC

Provider Business Mailing Address
First Line	:	5077 DALLAS HWY STE 105
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-4510
Country	:	US
Telephone Number	:	862-395-5247
Fax Number	:	862-395-5247

Provider Business Practice Location Address
First Line	:	5077 DALLAS HWY STE 105
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-4510
Country	:	US
Telephone Number	:	862-395-5247
Fax Number	:	862-395-5247

Authorized Official
Title or Position	:	OWNER
Name	:	LORETHA WILSON
Credential	:
Telephone Number	:	862-395-5247

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “TALK TREE SPEECH THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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