Organization
HILLSIDE SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN SPARKMAN M.ED. (OWNER)
(706) 897-5489
Entity
Organization
Contact information
Practice address
185 NICHOLSON FARM RD, BLAIRSVILLE, GA 30512-2814
(706) 897-5489
Mailing address
185 NICHOLSON FARM RD, BLAIRSVILLE, GA 30512-2814
(706) 897-5489
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
SLP007736
GA
Other
Enumeration date
04/07/2014
Last updated
04/18/2014
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