Provider Demographics
NPI:1427177153
Name:KIRKLAND, LARHONDA (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LARHONDA
Middle Name:
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 GLENDA TRCE STE F
Mailing Address - Street 2:#336
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-3868
Mailing Address - Country:US
Mailing Address - Phone:404-790-1958
Mailing Address - Fax:678-423-8841
Practice Address - Street 1:90 GLENDA TRCE STE F
Practice Address - Street 2:#336
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-3868
Practice Address - Country:US
Practice Address - Phone:404-790-1958
Practice Address - Fax:678-423-8841
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005869235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist