Provider Demographics
NPI:1366950388
Name:TALK SPEECH & LANGUAGE THERAPY, LLC
Entity type:Organization
Organization Name:TALK SPEECH & LANGUAGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:813-300-8819
Mailing Address - Street 1:1218 N DECATUR RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2308
Mailing Address - Country:US
Mailing Address - Phone:813-300-8819
Mailing Address - Fax:
Practice Address - Street 1:690 MIAMI CIR NE STE 680
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3015
Practice Address - Country:US
Practice Address - Phone:770-302-6902
Practice Address - Fax:770-302-6902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007896235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty