Organization
ASPIRE PEDIATRIC THERAPY OF GA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET VAN BUREN (OWNER)
(770) 965-1861
Entity
Organization
Contact information
Practice address
7367 SPOUT SPRINGS RD, SUITE 125, FLOWERY BRANCH, GA 30542-5519
(770) 965-1861
(770) 965-1863
Mailing address
7367 SPOUT SPRINGS RD, SUITE 125, FLOWERY BRANCH, GA 30542-5519
(770) 965-1861
(770) 965-1863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007398
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP00398
GA SECRETARY OF STATE LICENSING BOARD
GA
Enumeration date
04/21/2014
Last updated
04/21/2014
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