Individual
MRS. MADELYNN LORRAINE SPEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACII
Contact information
Practice address
44 DARBYS CROSSING DR STE 206C, HIRAM, GA 30141
(770) 222-8535
(770) 222-8536
Mailing address
PO BOX 850, POWDER SPRINGS, GA 30127-0850
(678) 681-4001
(678) 217-5742
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1911-R
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1911-R
SUBSTANCE ABUSE TREATMENT
GA
Enumeration date
04/07/2010
Last updated
07/23/2018
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