Organization
SIMPLY SPEECH AND LANGUAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KACEY CIVITELLA MS, CCC-SLP (OWNER)
(904) 417-3226
Entity
Organization
Contact information
Practice address
3916 BATTEY ST, SAVANNAH, GA 31405-3412
(904) 417-3226
Mailing address
3916 BATTEY ST, SAVANNAH, GA 31405-3412
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003196093C
—
GA
Enumeration date
07/17/2020
Last updated
07/17/2020
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