Organization
PEACH SPEECH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRIAM KATRINA ROBINSON M.ED., CCC-SLP (OWNER)
(404) 643-6098
Entity
Organization
Contact information
Practice address
5190 ISLAND DR, STONE MOUNTAIN, GA 30087-4248
(404) 643-6098
(877) 245-3717
Mailing address
5190 ISLAND DR, STONE MOUNTAIN, GA 30087-4248
(404) 643-6098
(877) 245-3717
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005420
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003122698A
—
GA
Enumeration date
07/23/2012
Last updated
07/23/2012
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