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SPEECH PATHOLOGY ASSOCIATES OF SOUTH EAST GEORGIA PC NPI 1083727325


NPI Information

NPI: 1083727325
Provider Name: SPEECH PATHOLOGY ASSOCIATES OF SOUTH EAST GEORGIA, PC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
2976 US HIGHWAY 84
BLACKSHEAR, GA
ZIP 31516
Phone: (912) 807-8255
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SPEECH PATHOLOGY ASSOCIATES OF SOUTH EAST GEORGIA, PC is a speech language pathologist in Blackshear, 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. SPEECH PATHOLOGY ASSOCIATES OF SOUTH EAST GEORGIA, PC NPI is 1083727325. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2976 US HIGHWAY 84
BLACKSHEAR, GA
ZIP 31516-601
Phone: (912) 807-8255
Fax: (912) 807-8256

The provider's authorized official is Shannon S Bennett .
The authorized official title is Owner and has the following contact phone number (912) 449-9923.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 7/29/2009.


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 PathologistSLP003867GEORGIAYes

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
1000731464CMEDICAIDGEORGIA

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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