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Organization

FAIRBURN SPEECH & SWALLOW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ASHANTI TARUVINGA M.ED. CCC-SLP (PART OWNER/ SERVICE PROVIDER)
(770) 774-2223
Entity
Organization

Contact information

Practice address
7863 HEATHMORE DR, FAIRBURN, GA 30213-7418
(770) 774-2223
(770) 774-2223
Mailing address
7863 HEATHMORE DR, FAIRBURN, GA 30213-7418
(770) 774-2223
(770) 774-2223

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007350
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003125147A
GA
Enumeration date
04/05/2013
Last updated
04/05/2013
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