Organization
SPEECH ASSESSMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES NELSON (CREDENTIALING)
(678) 438-7168
Entity
Organization
Contact information
Practice address
175 BRADFORD SQ STE A, FAYETTEVILLE, GA 30215-1967
(678) 438-7168
(470) 377-8097
Mailing address
210 MCINTOSH PLACE DR, FAYETTEVILLE, GA 30214-7384
(678) 438-7168
(707) 377-8097
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006202
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003209834D
—
GA
Enumeration date
04/15/2009
Last updated
12/11/2018
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