Provider Demographics
NPI:1659883536
Name:OCONEE SPEECH-LANGUAGE SOLUTIONS
Entity Type:Organization
Organization Name:OCONEE SPEECH-LANGUAGE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:CUMBUS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:706-202-1141
Mailing Address - Street 1:1175 OGLETHORPE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2129
Mailing Address - Country:US
Mailing Address - Phone:706-202-1141
Mailing Address - Fax:
Practice Address - Street 1:1175 OGLETHORPE AVE STE B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2129
Practice Address - Country:US
Practice Address - Phone:706-202-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty