Provider Demographics
NPI:1609080225
Name:CHAPPELL, TOMIKA (SLP)
Entity Type:Individual
Prefix:
First Name:TOMIKA
Middle Name:
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2894 PORT ROYAL LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-2770
Mailing Address - Country:US
Mailing Address - Phone:404-729-2520
Mailing Address - Fax:404-243-6796
Practice Address - Street 1:2771 COLUMBIA DRIVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034
Practice Address - Country:US
Practice Address - Phone:404-919-2665
Practice Address - Fax:404-390-2221
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA242000460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist