Provider Demographics
NPI:1558906297
Name:KIDMUNICATION, LLC
Entity Type:Organization
Organization Name:KIDMUNICATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:ALSUP
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:470-277-3004
Mailing Address - Street 1:540 POWDER SPRINGS ST STE C20
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-3561
Mailing Address - Country:US
Mailing Address - Phone:470-277-3004
Mailing Address - Fax:844-305-1030
Practice Address - Street 1:540 POWDER SPRINGS ST STE C20
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3561
Practice Address - Country:US
Practice Address - Phone:470-277-3004
Practice Address - Fax:844-305-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003219473BMedicaid