Provider Demographics
NPI:1982229142
Name:KERNS, MARGARET (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:KERNS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 E PACES FERRY RD NE APT 1033
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-3360
Mailing Address - Country:US
Mailing Address - Phone:256-996-7856
Mailing Address - Fax:
Practice Address - Street 1:4651 ROSWELL RD STE F501
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3051
Practice Address - Country:US
Practice Address - Phone:256-996-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty