Phillips, Demetria L

Phillips, Demetria L is an sole proprietor health care provider with primary practice located at 2623 Whispering Pines Dr , Grayson GA 30017-2859. 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. Phillips, Demetria L can be contacted via phone (770) 875-2331.

Contact Information

Primary practice address
2623 Whispering Pines Dr Grayson GA 30017-2859
Phone: (770) 875-2331
Fax: (770) 978-0077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005115 Georgia

Profile Details

NPI number 1699846766
LBN Legal business name Phillips, Demetria L
Credentials M.ED., CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 12th, 2006
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699846766 NPPES
Georgia Other 12038676 ASHA #
Georgia Other SLP005115 ASHA #
Georgia MEDICAID 10037022 ASHA #
Georgia MEDICAID 305510 ASHA #

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