Chandler Brown

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

NPI 1346799467 · NPPES record last updated Sep 30, 2016

Key facts

NPI
1346799467
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
PCET002397 (GA)
Practice address
225 Wes Park Dr
Perry, GA 31069-4829
Phone
(478) 987-1610
Fax
(973) 965-4580
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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
PCET002397GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Word of Mouth Therapy Speech-Language Pathologist Past Accepting new patients
The Speech Path LLC Speech-Language Pathologist Past Accepting new patients
The Speech Path Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PCET002397 GA Yes

Addresses

Primary practice location

225 Wes Park Dr
Perry, GA 31069-4829

Mailing address

225 Wes Park Dr
Perry, GA 31069-4829
Phone (478) 987-1610

Other providers in Perry, GA

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

Sources for this page

Verify at the official NPI Registry.