Provider Demographics
NPI:1760828883
Name:LOGOS THERAPY, LLC
Entity Type:Organization
Organization Name:LOGOS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:SEMONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:706-248-1281
Mailing Address - Street 1:1109 HIGHWAY 211 NE
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-3216
Mailing Address - Country:US
Mailing Address - Phone:706-248-1281
Mailing Address - Fax:
Practice Address - Street 1:1109 HIGHWAY 211 NE
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-3216
Practice Address - Country:US
Practice Address - Phone:706-248-1281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006821235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty