| Doctor Name: | MS. THERESA MARIE TAKACS |
| NPI Number: | 1598018814 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED, CCC-SLP |
| License Number: | SLP002020 |
| Business Practice Address: | 7985 Knight Rd Gainesville, GA - 305066427 |
| Business Phone Number: | 7707814899 |
| Business Fax Number: | |
| Mailing Address: | 6268 Cove Creek Dr, FLOWERY BRANCH |
| State: | GA |
| Postal Code: | 305422632 |
| Phone Number: | 6788287091 |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2012 |
| NPI Last Update Date: | 10/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP002020 |
| 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 |