Provider Demographics
NPI:1538592530
Name:THERAPEUTIC SPEECH AND LANGUAGE SERVICES INC.
Entity type:Organization
Organization Name:THERAPEUTIC SPEECH AND LANGUAGE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:YON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:404-932-0696
Mailing Address - Street 1:302 PONCE DE LEON PL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-5122
Mailing Address - Country:US
Mailing Address - Phone:404-932-0696
Mailing Address - Fax:404-973-0756
Practice Address - Street 1:390 17TH ST NW
Practice Address - Street 2:#3063
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30363-2000
Practice Address - Country:US
Practice Address - Phone:404-932-0696
Practice Address - Fax:404-973-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005950235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty