Provider Demographics
NPI:1154906238
Name:GEORGIA SPEECH THERAPY LLC
Entity type:Organization
Organization Name:GEORGIA SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:WARGA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:404-735-9982
Mailing Address - Street 1:1545 BEECHCLIFF DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3825
Mailing Address - Country:US
Mailing Address - Phone:404-735-9982
Mailing Address - Fax:
Practice Address - Street 1:1545 BEECHCLIFF DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3825
Practice Address - Country:US
Practice Address - Phone:404-735-9982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty