Provider Demographics
NPI:1831861905
Name:EXPRESSIONS SPEECH SERVICES, LLC
Entity type:Organization
Organization Name:EXPRESSIONS SPEECH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SANJENETTA
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC-SLP
Authorized Official - Phone:478-227-3187
Mailing Address - Street 1:228 E POPLAR ST STE D
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-3401
Mailing Address - Country:US
Mailing Address - Phone:478-227-3187
Mailing Address - Fax:
Practice Address - Street 1:228 E POPLAR ST STE D
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-3401
Practice Address - Country:US
Practice Address - Phone:478-227-3187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty