| Doctor Name: | VANESSA RISINGMOON |
| NPI Number: | 1073962437 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SLP009220 |
| Business Practice Address: | 4500 Satellite Blvd Ste 2250 Duluth, GA - 300965037 |
| Business Phone Number: | 8003812195 |
| Business Fax Number: | 8883810822 |
| Mailing Address: | 897 Tanner Dr, SCOTTDALE |
| State: | GA |
| Postal Code: | 300791036 |
| Phone Number: | 8003812195 |
| Fax Number: | 8883810822 |
| NPI Enumeration Date: | 06/07/2016 |
| NPI Last Update Date: | 06/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP009220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |