Provider Demographics
NPI:1205694981
Name:ATLANTA SPEECH AND LANGUAGE LLC
Entity type:Organization
Organization Name:ATLANTA SPEECH AND LANGUAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDRICH PRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-520-9545
Mailing Address - Street 1:2866 THORNRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-5134
Mailing Address - Country:US
Mailing Address - Phone:404-520-9545
Mailing Address - Fax:
Practice Address - Street 1:2866 THORNRIDGE LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-5134
Practice Address - Country:US
Practice Address - Phone:404-520-9545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty