Organization
CLESIAVENTURES
Active
Other names
ClesiaSpeech, Clesia Speech
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LOUISE DUNCAN M.A. CCC-SLP (SPEECH PATHOLOGIST)
(404) 805-2875
Entity
Organization
Contact information
Practice address
7454 HANNOVER PKWY S STE 235, STOCKBRIDGE, GA 30281-6866
(470) 491-7707
(404) 738-2128
Mailing address
2330 KENNESAW OAKS CT NW, KENNESAW, GA 30152-4269
(866) 925-7840
(866) 925-7840
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SLP006225
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410111878A
—
GA
Enumeration date
07/20/2010
Last updated
09/20/2021
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