Larcomb, Audrey
Larcomb, Audrey is an sole proprietor health care provider with primary practice located at 6572 River Park Dr Ste 101 , Riverdale GA 30274-2214. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Larcomb, Audrey can be contacted via phone (678) 262-1833.Contact Information
Primary practice address
6572 River Park Dr Ste 101
Riverdale GA 30274-2214
Phone: (678) 262-1833
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | PCET003287 | Georgia |
Profile Details
| NPI number | 1609447887 |
|---|---|
| LBN Legal business name | Larcomb, Audrey |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 8th, 2021 |
| Last updated | Jul 8th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609447887 | NPPES |
| Georgia | Other | PCET003287 | SLP STATE LICENSE |
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