Provider Demographics
NPI:1689281032
Name:CHIT CHAT PEDIATRIC THERAPY LLC
Entity Type:Organization
Organization Name:CHIT CHAT PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:MCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:912-245-1865
Mailing Address - Street 1:97 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:SOPERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30457-2752
Mailing Address - Country:US
Mailing Address - Phone:912-245-1865
Mailing Address - Fax:
Practice Address - Street 1:97 CARTER ST
Practice Address - Street 2:
Practice Address - City:SOPERTON
Practice Address - State:GA
Practice Address - Zip Code:30457-2752
Practice Address - Country:US
Practice Address - Phone:912-245-1865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty