Provider Demographics
NPI:1326262437
Name:GREATER ATLANTA SPEECH & LANGUAGE CLINICS, INC.
Entity Type:Organization
Organization Name:GREATER ATLANTA SPEECH & LANGUAGE CLINICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELKAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC
Authorized Official - Phone:770-418-1778
Mailing Address - Street 1:3483 SATELLITE BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8693
Mailing Address - Country:US
Mailing Address - Phone:770-418-1778
Mailing Address - Fax:770-418-1794
Practice Address - Street 1:3483 SATELLITE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8693
Practice Address - Country:US
Practice Address - Phone:770-418-1778
Practice Address - Fax:770-418-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty