Provider Demographics
NPI:1750895074
Name:GILES, ASHA BRIANA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:BRIANA
Last Name:GILES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 COBB GALLERIA PKWY STE 223
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5927
Mailing Address - Country:US
Mailing Address - Phone:404-814-7166
Mailing Address - Fax:
Practice Address - Street 1:3200 COBB GALLERIA PKWY STE 223
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5927
Practice Address - Country:US
Practice Address - Phone:404-814-7166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-22
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP012377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty