Provider Demographics
NPI:1538324504
Name:THE TANKSLEY CRAWFORD GROUP
Entity Type:Organization
Organization Name:THE TANKSLEY CRAWFORD GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LASHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANKSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSM, MED, CCC-SLP
Authorized Official - Phone:912-604-5597
Mailing Address - Street 1:503 TYLER WOODS CT
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-6303
Mailing Address - Country:US
Mailing Address - Phone:912-604-5597
Mailing Address - Fax:706-650-5773
Practice Address - Street 1:503 TYLER WOODS CT
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-6303
Practice Address - Country:US
Practice Address - Phone:912-604-5597
Practice Address - Fax:706-650-5773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty