Kelly Gawel, CCC-SLP/L

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

NPI 1477063600 · NPPES record last updated Oct 2, 2017

Key facts

NPI
1477063600
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP009842 (GA)
Practice address
7824 Tyree Rd
Winston, GA 30187-1230
Phone
(770) 990-5989
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
Yes

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
SLP009842GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Clinic for Speech and Language LLC Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP009842 GA Yes

Addresses

Primary practice location

7824 Tyree Rd
Winston, GA 30187-1230

Mailing address

7824 Tyree Rd
Winston, GA 30187-1230
Phone (770) 990-5989

Other providers in Winston, GA

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

Sources for this page

Verify at the official NPI Registry.