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Organization
ASPIRE PEDIATRIC THERAPY OF GA, LLC
Active
Organization
ASPIRE PEDIATRIC THERAPY OF GA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET VAN BUREN (OWNER)
(770) 965-1861
Entity
Organization
Contact information
Practice address
7367 SPOUT SPRINGS RD, SUITE 125, FLOWERY BRANCH, GA 30542-5519
(770) 965-1861
(770) 965-1863
Mailing address
7367 SPOUT SPRINGS RD, SUITE 125, FLOWERY BRANCH, GA 30542-5519
(770) 965-1861
(770) 965-1863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007398
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP00398
GA SECRETARY OF STATE LICENSING BOARD
GA
Enumeration date
04/21/2014
Last updated
04/21/2014
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