1326481862 NPI number — ANTOINETTE L. STEWART M.S., CCC-SLP

Table of content: ANTOINETTE L. STEWART M.S., CCC-SLP (NPI 1326481862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326481862 NPI number — ANTOINETTE L. STEWART M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEWART
Provider First Name:
ANTOINETTE
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEWART
Provider Other First Name:
TONI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC-SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1326481862
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4904 VININGS RIDGE TRL SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MABLETON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30126-5905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-874-3208
Provider Business Mailing Address Fax Number:
770-874-3208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6600 PEACHTREE DUNWOODY RD NE
Provider Second Line Business Practice Location Address:
BLDG 400, STE 125
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30328-6773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-587-9922
Provider Business Practice Location Address Fax Number:
866-587-9993
Provider Enumeration Date:
04/15/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP007288 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com