Provider Demographics
NPI:1225894207
Name:SOUTHERN SPEECH SERVICES
Entity Type:Organization
Organization Name:SOUTHERN SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:678-243-0070
Mailing Address - Street 1:500 BUFORD HWY STE 1001-110
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7808
Mailing Address - Country:US
Mailing Address - Phone:678-243-0070
Mailing Address - Fax:678-250-0073
Practice Address - Street 1:500 BUFORD HWY STE 1001-110
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7808
Practice Address - Country:US
Practice Address - Phone:678-243-0070
Practice Address - Fax:678-250-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty