Provider Demographics
NPI:1750444964
Name:POSITIVE OUTLOOK, LLP
Entity Type:Organization
Organization Name:POSITIVE OUTLOOK, LLP
Other - Org Name:POSITIVE OUTLOOK, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LAWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:404-381-4108
Mailing Address - Street 1:2451 CUMBERLAND PKWY SE
Mailing Address - Street 2:SUITE 3606
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6136
Mailing Address - Country:US
Mailing Address - Phone:404-381-4108
Mailing Address - Fax:404-381-3043
Practice Address - Street 1:696 MOUNT ZION RD
Practice Address - Street 2:SUITE 3B
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1597
Practice Address - Country:US
Practice Address - Phone:404-381-4108
Practice Address - Fax:404-381-3043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00972573BMedicaid