Organization
KIDS SPEAK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY BYRD (OWNER)
(470) 471-3075
Entity
Organization
Contact information
Practice address
1 W COURT SQ, DECATUR, GA 30030-2538
(470) 461-3075
Mailing address
4512 JACKAM RIDGE CT, LITHONIA, GA 30038-6280
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083158521
NPI
—
Enumeration date
03/14/2020
Last updated
04/21/2021
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