Provider Demographics
NPI:1578262945
Name:HARMONY GROVE SPEECH LANGUAGE THERAPY LLC
Entity Type:Organization
Organization Name:HARMONY GROVE SPEECH LANGUAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNDI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:480-299-1646
Mailing Address - Street 1:843 FLAGSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-1914
Mailing Address - Country:US
Mailing Address - Phone:480-299-1646
Mailing Address - Fax:
Practice Address - Street 1:843 FLAGSTONE WAY
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-1914
Practice Address - Country:US
Practice Address - Phone:480-299-1646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty