Brianna Tamera Avant
Individual provider Active NPI Speech-Language Pathologist · Powder Springs, GA
NPI 1699452409 · NPPES record last updated Apr 5, 2025
Key facts
- NPI
- 1699452409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP012613 (GA)
- Practice address
- 3865 Chasemont Dr
Powder Springs, GA 30127-5635 - Phone
- (347) 707-0161
- NPI assigned
- Jul 3, 2023
- 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 |
|---|---|---|---|
| SLP012613 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP012613 | GA | Yes |
Addresses
Primary practice location
3865 Chasemont Dr
Powder Springs, GA 30127-5635
Mailing address
3865 Chasemont Dr
Powder Springs, GA 30127-5635
Phone (347) 707-0161
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All providers in Powder Springs, 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 Apr 5, 2025. 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.