Elena Freeman

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

NPI 1467014308 · NPPES record last updated Jul 1, 2019

Key facts

NPI
1467014308
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP010684 (GA)
Practice address
3905 Johns Creek CT Ste 250
Suwanee, GA 30024-1226
Phone
(770) 888-5221
NPI assigned
Jul 1, 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)
No

State licenses

LicenseStateTypeSpecialty
SLP010684GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Creek Therapy Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP010684 GA Yes

Addresses

Primary practice location

3905 Johns Creek CT Ste 250
Suwanee, GA 30024-1226

Mailing address

3905 Johns Creek CT Ste 250
Suwanee, GA 30024-1226
Phone (770) 888-5221

Other providers in Suwanee, GA

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

Sources for this page

Verify at the official NPI Registry.