Provider Demographics
NPI:1386803450
Name:SPEECH THERAPY UNLIMITED, LLC
Entity type:Organization
Organization Name:SPEECH THERAPY UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD CCC-SLP
Authorized Official - Phone:478-275-8844
Mailing Address - Street 1:PO BOX 8259
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31040-8259
Mailing Address - Country:US
Mailing Address - Phone:478-275-8844
Mailing Address - Fax:478-275-2365
Practice Address - Street 1:806 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-6306
Practice Address - Country:US
Practice Address - Phone:478-275-8844
Practice Address - Fax:478-275-2365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003139235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty