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Organization
PRIMARY PATHWAYS, LLC
Active
Organization
PRIMARY PATHWAYS, LLC
Active
Other names
Primary Pathways Speech & Language Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE D MURRY PH.D. (AGENT)
(770) 500-5508
Entity
Organization
Contact information
Practice address
1258 CONCORD RD SE STE 104, SMYRNA, GA 30080-4302
(770) 500-5508
(404) 597-4050
Mailing address
3904 N DRUID HILLS RD # 214, DECATUR, GA 30033-3105
(770) 500-5508
(404) 597-4050
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
674689092D
—
GA
Enumeration date
04/04/2012
Last updated
06/18/2020
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