Organization Name: | ATLANTA WEST SPEECH-LANGUAGE PATHOLOGY AND ASSOCIATES, LLC |
NPI Number: | 1558622720 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | D'JARIS RENEE WHITE (SPEECH-LANGUAGE PATHOLOGIST) |
Mailing Address: | 6732 Spring St Douglasville |
State: | GA US |
Postal Code: | 301341760 |
Phone Number: | 6789017788 |
Fax Number: | 8664004772 |
NPI Enumeration Date: | 06/05/2012 |
NPI Last Update Date: | 06/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP005812 |
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 |