Provider Demographics
NPI:1629236971
Name:FIRST WORDS SPEECH SERVICES, LLC
Entity Type:Organization
Organization Name:FIRST WORDS SPEECH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WYTONA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:770-438-6928
Mailing Address - Street 1:1750 POWDER SPRINGS RD SW
Mailing Address - Street 2:SUITE 190, PMB 115
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4850
Mailing Address - Country:US
Mailing Address - Phone:770-438-6928
Mailing Address - Fax:678-623-5387
Practice Address - Street 1:1800 LAKE PARK DR SE
Practice Address - Street 2:SUITE 102
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7639
Practice Address - Country:US
Practice Address - Phone:770-438-6928
Practice Address - Fax:678-623-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP2031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty