Elizabeth Hardy, SLP

Individual provider Active NPI Speech-Language Pathologist · Forsyth, GA

NPI 1104488683 · NPPES record last updated Jul 3, 2019

Key facts

NPI
1104488683
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP004366 (GA)
Practice address
120 N Lee St Ste E
Forsyth, GA 31029-2122
Phone
(478) 994-3390
Fax
(478) 845-6252
NPI assigned
Jul 3, 2019
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)
Yes

State licenses

LicenseStateTypeSpecialty
SLP004366GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dialysis Center of Forsyth LLC Past
since Jul 5, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP004366 GA Yes

Addresses

Primary practice location

120 N Lee St Ste E
Forsyth, GA 31029-2122

Mailing address

120 N Lee St Ste E
Forsyth, GA 31029-2122
Phone (478) 994-3390

Other providers in Forsyth, GA

All providers in Forsyth, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.