Provider Demographics
NPI:1588262257
Name:SOUTHERN SPEECH SOLUTIONS LLC
Entity type:Organization
Organization Name:SOUTHERN SPEECH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:912-590-2516
Mailing Address - Street 1:151 PLEASANT LN
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-8028
Mailing Address - Country:US
Mailing Address - Phone:912-590-2516
Mailing Address - Fax:912-214-5206
Practice Address - Street 1:151 PLEASANT LN
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-8028
Practice Address - Country:US
Practice Address - Phone:912-590-2516
Practice Address - Fax:912-214-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech