Allison J Tkaczuk

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP010247 Issued in GA

Practice address

522 E Ponce de Leon Ave
Decatur, GA 30030-1967

Phone

(410) 913-1174

NPI assigned

Jan 29, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1902668486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 E PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301967",
            "telephone_number": "410-913-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 E PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301967",
            "telephone_number": "410-913-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACZUK",
        "first_name": "ALLISON",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Coleman Tillman, CRNA
• Danielle Alicia Timmons, D.O.
• Timothy J O'Shea DDS PA
• Tinsley Curry OT
• Manuel Nick Tissura
• TN Health Solutions
• Melissa Tobin-D'Angelo, MD
• Tojija, LLC
• Kevin Bernard Tolbert, PT, DPT
• Laura Tolbert, CPC,MSLC

• Speech-Language Pathologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.