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Organization
THERAPEDIA, LLC
Active
Organization
THERAPEDIA, LLC
Active
Other names
Therapedia, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EBONY JASPER (SPEECH-LANGUAGE PATHOLOGIST)
(678) 830-6632
Entity
Organization
Contact information
Practice address
1432 PENHURST DR, LAWRENCEVILLE, GA 30043-8165
(678) 830-6632
Mailing address
1432 PENHURST DR, LAWRENCEVILLE, GA 30043-8165
(678) 830-6632
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004108
GA
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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