Organization
PRENDERGAST GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKA PRENDERGAST MSCCCSLP (DIRECTOR)
(404) 474-1627
Entity
Organization
Contact information
Practice address
166 WATERCRESS CT, STOCKBRIDGE, GA 30281-7261
(404) 474-1627
Mailing address
166 WATERCRESS CT, STOCKBRIDGE, GA 30281-7261
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861686016
—
GA
Enumeration date
05/25/2020
Last updated
05/25/2020
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