Madison Scott Chase, SLP

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

NPI 1922617455 · NPPES record last updated Jul 30, 2020

Key facts

NPI
1922617455
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP01135 (GA)
Practice address
1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640
Phone
(678) 632-6765
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

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
SLP01135GAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP01135 GA Yes

Addresses

Primary practice location

1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640

Mailing address

60 11TH St NE Apt 1618
Atlanta, GA 30309-4380
Phone (908) 489-5746

Other providers in Tyrone, GA

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

Sources for this page

Verify at the official NPI Registry.