Provider Demographics
NPI:1508254202
Name:MEREDITH WHITE SPEECH PATHOLOGY INC
Entity Type:Organization
Organization Name:MEREDITH WHITE SPEECH PATHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ALVAREZ-ROWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-228-8558
Mailing Address - Street 1:1777 NORTHEAST EXPY NE
Mailing Address - Street 2:STE 120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2480
Mailing Address - Country:US
Mailing Address - Phone:404-228-8558
Mailing Address - Fax:404-228-8659
Practice Address - Street 1:1777 NORTHEAST EXPY NE
Practice Address - Street 2:STE 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2480
Practice Address - Country:US
Practice Address - Phone:404-228-8558
Practice Address - Fax:404-228-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-03
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000860604DMedicaid