Provider Demographics
NPI:1073168464
Name:KNOWLES, PARIZAH (SLP)
Entity Type:Individual
Prefix:
First Name:PARIZAH
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 SATELLITE BLVD STE 2250
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5047
Mailing Address - Country:US
Mailing Address - Phone:800-381-2195
Mailing Address - Fax:888-381-0822
Practice Address - Street 1:3875 AUSTELL RD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1153
Practice Address - Country:US
Practice Address - Phone:800-381-2195
Practice Address - Fax:888-381-0822
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010293235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist