Ricki Botsford

Individual provider Active NPI Speech-Language Pathologist · Richmond Hill, GA

NPI 1063253185 · NPPES record last updated Jun 3, 2024

Key facts

NPI
1063253185
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
PCET004011 (GA)
Practice address
2453 US Highway 17
Richmond Hill, GA 31324-5959
Phone
(912) 445-5612
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PCET004011GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chatterbox Pediatric Therapy Speech-Language Pathologist Past
since Aug 6, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PCET004011 GA Yes

Addresses

Primary practice location

2453 US Highway 17
Richmond Hill, GA 31324-5959

Mailing address

138 Dukes Way
Savannah, GA 31419-8953

Other providers in Richmond Hill, GA

All providers in Richmond Hill, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.