Doctor Name: | LISA SCORDALAKIS |
NPI Number: | 1801255161 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 14052341 |
Business Practice Address: | 5400 Laurel Springs Pkwy Bldg 400 #404 Suwanee, GA - 300246056 |
Business Phone Number: | 6784739954 |
Business Fax Number: | 6789310105 |
Mailing Address: | 77 E Andrews Dr Nw, Apt # 3235 ATLANTA |
State: | GA |
Postal Code: | 303051370 |
Phone Number: | 8584723022 |
Fax Number: | |
NPI Enumeration Date: | 02/15/2016 |
NPI Last Update Date: | 02/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 14052341 |
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 |