Kirsten Mallory, SLP
Individual provider Active NPI Speech-Language Pathologist · Woodbury, GA
NPI 1386065571 · NPPES record last updated Aug 8, 2022
Key facts
- NPI
- 1386065571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP008337 (GA)
- Practice address
- 229 Upper Cove Rd
Woodbury, GA 30293-3906 - Phone
- (808) 347-9115
- NPI assigned
- Dec 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| SLP008337 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aloha Swim and Speech Therapy | Speech-Language Pathologist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP008337 | GA | Yes |
Addresses
Primary practice location
229 Upper Cove Rd
Woodbury, GA 30293-3906
Mailing address
229 Upper Cove Rd
Woodbury, GA 30293-3906
Phone (808) 347-9115
Other providers in Woodbury, GA
- Custom Healthcare, LLC
- Timothy Peter Daniel
- Morgan Garrett
- Timothy Joseph Gravel
- Amanda Hardnett
- Meriwether Healthcare, L.L.C.
- Merwiether Co Health Department
- Janssen Owens
- Audrey Denise Ross
- Southwest Medical Clinic, Inc
All providers in Woodbury, 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 8, 2022. 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.