Provider Demographics
NPI:1730354770
Name:LANDAU, TONI MARIE (MA CCC-A)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:MARIE
Last Name:LANDAU
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:MISS
Other - First Name:TONI
Other - Middle Name:MARIE
Other - Last Name:KUNKEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:770-677-6135
Mailing Address - Fax:
Practice Address - Street 1:20 GLENLAKE DR
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-677-6135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003747231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist