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Organization
MANOR OF SPEAKING, LLC
Active
Organization
MANOR OF SPEAKING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COURTNEY EDMUNDS JACOBS CCC (SPEECH-LANGUAGE PATHOLOGIST)
(229) 928-8202
Entity
Organization
Contact information
Practice address
511 W FORSYTH ST, SUITE E, AMERICUS, GA 31709-3465
(229) 928-8202
(229) 928-8205
Mailing address
511 W FORSYTH ST, SUITE E, AMERICUS, GA 31709-3465
(229) 928-8202
(229) 928-8205
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
SLP006018
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205012911
INDIVIDUAL NPI
GA
05
—
414174596B
—
GA
Enumeration date
09/04/2009
Last updated
09/09/2009
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