NPIMap

Allison Penney

Individual provider Active NPI Speech-Language Pathologist · Saint Marys, GA

NPI 1770002016 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1770002016
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
PCET002632 (GA)
Practice address
2015 Osborne Rd Ste a
Saint Marys, GA 31558-9164
Phone
(912) 576-9603
NPI assigned
Sep 19, 2017
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
PCET002632GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crew Speech & Language Group, Inc Speech-Language Pathologist Past
since Jul 24, 2022		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PCET002632 GA Yes

Addresses

Primary practice location

2015 Osborne Rd Ste a
Saint Marys, GA 31558-9164

Mailing address

2015 Osborne Rd Ste a
Saint Marys, GA 31558-9164
Phone (912) 576-9603

Other providers in Saint Marys, GA

All providers in Saint Marys, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.