Provider Demographics
NPI:1801402011
Name:AWINO SPEAKS LLC
Entity Type:Organization
Organization Name:AWINO SPEAKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PELESIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:914-924-3768
Mailing Address - Street 1:2502 AMUR CT
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7451
Mailing Address - Country:US
Mailing Address - Phone:914-924-3768
Mailing Address - Fax:
Practice Address - Street 1:125 LEE BYRD RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2310
Practice Address - Country:US
Practice Address - Phone:914-924-3768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center