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Organization

SHINE SPEECH LANGUAGE THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEIDI A BRITZ M.ED, CCC-SLP (OWNER)
(770) 337-5465
Entity
Organization

Contact information

Practice address
107 PILGRIM VILLAGE DR SUITE 400, CUMMING, GA 30040
(770) 337-5465
(678) 899-6333
Mailing address
505 LAKELAND PLZ STE 343, CUMMING, GA 30040-2807
(770) 337-5465
(678) 899-6333

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLP003981
SPEECH PATHOLOGY LICENSE
GA
Enumeration date
04/09/2019
Last updated
04/09/2019
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