Organization
PEDIATRIC THERAPY ON THE GO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYNN RICKARD M.ED., CCC-SLP (OWNER)
(229) 457-0337
Entity
Organization
Contact information
Practice address
2483 HERITAGE VLG STE 16314, SNELLVILLE, GA 30078-6140
(770) 799-8116
Mailing address
2483 HERITAGE VLG STE 16314, SNELLVILLE, GA 30078-6140
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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