Provider Demographics
NPI:1104539477
Name:CONNECTED SPEECH THERAPY SERVICES
Entity type:Organization
Organization Name:CONNECTED SPEECH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MED, CCC-SLP
Authorized Official - Phone:216-400-2113
Mailing Address - Street 1:8680 REDLAND CT
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-4379
Mailing Address - Country:US
Mailing Address - Phone:216-400-2113
Mailing Address - Fax:
Practice Address - Street 1:8680 REDLAND CT
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-4379
Practice Address - Country:US
Practice Address - Phone:216-400-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty