| Organization Name: | ASPIRE PEDIATRIC THERAPY OF GA, LLC |
| NPI Number: | 1477973261 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARGARET VAN BUREN (OWNER) |
| Mailing Address: | 7367 Spout Springs Rd Suite 125 Flowery Branch |
| State: | GA US |
| Postal Code: | 305425519 |
| Phone Number: | 7709651861 |
| Fax Number: | 7709651863 |
| NPI Enumeration Date: | 04/21/2014 |
| NPI Last Update Date: | 04/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP007398 |
| 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 |