Provider Demographics
NPI:1093063794
Name:HARRELSON SPEECH AND LANGUAGE THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:HARRELSON SPEECH AND LANGUAGE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:PADGETT
Authorized Official - Last Name:HARRELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC SLP
Authorized Official - Phone:229-315-1108
Mailing Address - Street 1:5 MUSCADINE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:GA
Mailing Address - Zip Code:31037-4039
Mailing Address - Country:US
Mailing Address - Phone:229-315-1108
Mailing Address - Fax:229-234-4286
Practice Address - Street 1:12 E OAK ST
Practice Address - Street 2:
Practice Address - City:MC RAE HELENA
Practice Address - State:GA
Practice Address - Zip Code:31055-4337
Practice Address - Country:US
Practice Address - Phone:229-315-1108
Practice Address - Fax:229-234-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty