Provider Demographics
NPI:1710313010
Name:TINY TALKERS THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:TINY TALKERS THERAPY SERVICES, INC.
Other - Org Name:S.M. TYLER, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-395-4578
Mailing Address - Street 1:960 DURHAM WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7950
Mailing Address - Country:US
Mailing Address - Phone:404-395-4578
Mailing Address - Fax:404-920-3396
Practice Address - Street 1:960 DURHAM WAY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7950
Practice Address - Country:US
Practice Address - Phone:404-395-4578
Practice Address - Fax:404-920-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004924252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000891943HMedicaid