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Organization
VERBAL CONCEPTS
Active
Organization
VERBAL CONCEPTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRETTA KALETO (CEO)
(770) 719-8840
Entity
Organization
Contact information
Practice address
175 CARNEGIE PL STE 137, FAYETTEVILLE, GA 30214-7903
(770) 719-8840
(770) 719-8850
Mailing address
175 CARNEGIE PL STE 137, FAYETTEVILLE, GA 30214-7903
(770) 719-8840
(770) 719-8850
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005911
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10045960
AMERIGOUP
GA
01
—
719199848A
PEACHSTATE HEALTH PLAN
GA
05
—
719199848A
—
GA
Enumeration date
02/09/2015
Last updated
02/09/2015
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