Provider Demographics
NPI:1255943429
Name:ASCEND SPEECH AND SWALLOWING LLC
Entity type:Organization
Organization Name:ASCEND SPEECH AND SWALLOWING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST/SOLEMEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:614-753-5588
Mailing Address - Street 1:2517 COLLINS PORT CV
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2787
Mailing Address - Country:US
Mailing Address - Phone:614-753-5588
Mailing Address - Fax:
Practice Address - Street 1:2517 COLLINS PORT CV
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2787
Practice Address - Country:US
Practice Address - Phone:614-753-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty