# SAMUEL B. ELLIOTT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Speech Services For Children
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639354962
- **Authorized official:** MR. SAMUEL B ELLIOTT M.ED.,CCC-SLP (SPEECH/LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (404) 835-2781

## Contact information

- **Practice address:** 434 MARIETTA ST NW, SUITE 104, ATLANTA, GA 30313-1737
- **Practice address phone:** (404) 835-2781
- **Practice address fax:** (404) 835-2781
- **Mailing address:** 434 MARIETTA ST NW, SUITE 104, ATLANTA, GA 30313-1737
- **Mailing address phone:** (404) 835-2781
- **Mailing address fax:** (404) 835-2781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | SLP001044 | GA | Yes |

## Other

- **Enumeration date:** 01/06/2008
- **Last updated:** 05/31/2013