Organization
SAMUEL B. ELLIOTT
Active
Other names
Speech Services For Children
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL B ELLIOTT M.ED.,CCC-SLP (SPEECH/LANGUAGE PATHOLOGIST)
(404) 835-2781
Entity
Organization
Contact information
Practice address
434 MARIETTA ST NW, SUITE 104, ATLANTA, GA 30313-1737
(404) 835-2781
(404) 835-2781
Mailing address
434 MARIETTA ST NW, SUITE 104, ATLANTA, GA 30313-1737
(404) 835-2781
(404) 835-2781
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SLP001044
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000697111J
—
GA
01
—
SLP001044
GA. LICENSE
—
Enumeration date
01/06/2008
Last updated
05/31/2013
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