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FAIRBURN SPEECH & SWALLOW LLC NPI 1699018853


NPI Information

NPI: 1699018853
Provider Name: FAIRBURN SPEECH & SWALLOW, LLC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
7863 HEATHMORE DR
FAIRBURN, GA
ZIP 30213
Phone: (770) 774-2223
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FAIRBURN SPEECH & SWALLOW, LLC is a speech language pathologist in Fairburn, GA. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. FAIRBURN SPEECH & SWALLOW, LLC NPI is 1699018853. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7863 HEATHMORE DR
FAIRBURN, GA
ZIP 30213-418
Phone: (770) 774-2223
Fax: (770) 774-2223

The provider's authorized official is Ashanti Taruvinga .
The authorized official title is Part Owner/ Service Provider and has the following contact phone number (770) 774-2223.

The enumeration date for this NPI number is 4/5/2013 and was last updated on 4/5/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1235Z00000XSpeech-Language PathologistSLP007350GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003125147AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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