Provider Demographics
NPI:1992881841
Name:UGA SPEECH AND HEARING
Entity type:Organization
Organization Name:UGA SPEECH AND HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:ED S
Authorized Official - Phone:706-542-4559
Mailing Address - Street 1:593 ADERHOLD HALL
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602
Mailing Address - Country:US
Mailing Address - Phone:706-542-4598
Mailing Address - Fax:706-542-5348
Practice Address - Street 1:593 ADERHOLD HALL
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602
Practice Address - Country:US
Practice Address - Phone:706-542-4598
Practice Address - Fax:706-542-5348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1681231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA64BCBHNMedicare UPIN
GA64PCBGNMedicare UPIN