Organization
SMALL STEPS PEDIATRIC SPEECH THERAPY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA DANIELLE LONG M.ED, CCC-SLP (OWNER-SPEECH PATHOLOGIST)
(912) 667-6468
Entity
Organization
Contact information
Practice address
6 GABLES DR, POOLER, GA 31322-9693
(912) 667-6468
Mailing address
6 GABLES DR, POOLER, GA 31322-9693
(912) 667-6468
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SLP008055
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134193A
—
GA
Enumeration date
03/22/2015
Last updated
03/22/2015
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