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INDIVIDUAL EXPRESSIONS THERAPY LLC NPI 1073032884


NPI Information

NPI: 1073032884
Provider Name: INDIVIDUAL EXPRESSIONS THERAPY, LLC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
7421 DOUGLAS BLVD STE N446
DOUGLASVILLE, GA
ZIP 30135
Phone: (770) 731-8772
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INDIVIDUAL EXPRESSIONS THERAPY, LLC is a speech language pathologist in Douglasville, GA. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. INDIVIDUAL EXPRESSIONS THERAPY, LLC NPI is 1073032884. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7421 DOUGLAS BLVD STE N446
DOUGLASVILLE, GA
ZIP 30135-564
Phone: (770) 731-8772
Fax: (470) 300-0042

The provider's authorized official is Nilka Gordon .
The authorized official title is Owner/speech Pathologist and has the following contact phone number (770) 731-8772.

The enumeration date for this NPI number is 9/12/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language PathologistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003147217DMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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