Organization Name: | AZALEA REHAB SERVICES, LLC |
NPI Number: | 1992062426 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HEATHER DELANEY (OWNER) |
Mailing Address: | 2700 N Oak St Bldg, A Valdosta |
State: | GA US |
Postal Code: | 316021772 |
Phone Number: | 2292441667 |
Fax Number: | 2292448253 |
NPI Enumeration Date: | 04/22/2012 |
NPI Last Update Date: | 10/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP007569 |
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 |