Marlee Bedford
Individual provider Active NPI Speech-Language Pathologist · Blackshear, GA
NPI 1144639022 · NPPES record last updated Aug 5, 2014
Key facts
- NPI
- 1144639022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP008623 (GA)
- Practice address
- 949 Lakeview Drive
Blackshear, GA 31516 - Phone
- (912) 807-5006
- NPI assigned
- Aug 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP008623 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP008623 | GA | Yes |
Addresses
Primary practice location
949 Lakeview Drive
Blackshear, GA 31516
Mailing address
949 Lakeview Drive
Blackshear, GA 31516
NPI Registry JSON
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1144639022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "949 LAKEVIEW DRIVE",
"city": "BLACKSHEAR",
"state": "GA",
"postal_code": "31516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "949 LAKEVIEW DRIVE",
"city": "BLACKSHEAR",
"state": "GA",
"postal_code": "31516",
"telephone_number": "912-807-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDFORD",
"first_name": "MARLEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP008623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blackshear, GA
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- Alyssa Barth
- Kelli Beard
- Bennett Mobility Products LLC
- Grant Douglas Bennett
- Heidi Rose Bennett
- Shannon Strickland Bennett
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All providers in Blackshear, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.