Provider Demographics
NPI:1740369099
Name:CLEARLY SPEAKING INC
Entity type:Organization
Organization Name:CLEARLY SPEAKING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:VELLIQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC SLP L
Authorized Official - Phone:404-934-0605
Mailing Address - Street 1:PO BOX 6336
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30154-0023
Mailing Address - Country:US
Mailing Address - Phone:404-934-0605
Mailing Address - Fax:770-577-2816
Practice Address - Street 1:6732 SPRING ST
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1760
Practice Address - Country:US
Practice Address - Phone:404-934-0605
Practice Address - Fax:770-577-2816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00839781CMedicaid