| Mykiah Clark, | |
|
7985 Knight Rd, Gainesville, GA 30506-6427 | |
| (770) 781-4899 | |
| Not Available |
| Full Name | Mykiah Clark |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 7985 Knight Rd, Gainesville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740944388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (Georgia) | Primary |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1528419751 PECOS PAC ID: 2163339722 Enrollment ID: O20160830000411 |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1831619337 PECOS PAC ID: 2163339722 Enrollment ID: O20220916001457 |
| Mailing Address | Practice Location Address |
|---|---|
| Mykiah Clark, 10205 Parker Forest Dr, Dawsonville, GA 30534-3271 Ph: (615) 987-9851 | Mykiah Clark, 7985 Knight Rd, Gainesville, GA 30506-6427 Ph: (770) 781-4899 |
Bernateen Cunningham Bibb, ST Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2360 Murphy Blvd, Gainesville, GA 30504 Phone: 770-535-8372 Fax: 770-535-0252 | |
Northeast Georgia Speech Center, Inc. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 621 Spring St Se, Gainesville, GA 30501 Phone: 770-534-5141 Fax: 770-534-5141 | |
M&m Speech And Feeding Services, Llc. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 9680 Crestview Ter, Gainesville, GA 30506 Phone: 216-288-1613 | |
Jennifer Zonts, M.S.CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2360 Murphy Blvd, Gainesville, GA 30504 Phone: 770-535-8372 Fax: 770-535-0252 | |
Genevieve Kennett, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 500 Spring St Se Ste 101, Gainesville, GA 30501 Phone: 770-615-7676 | |
Alyssa Larrece Groover, M.ED, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 428 S Enota Dr Ne, Gainesville, GA 30501 Phone: 678-616-3099 | |
Ms. Janice Louise Martin, MS-CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 743 Spring St Ne, Northeast Ga Medical Center, Gainesville, GA 30501 Phone: 770-533-8251 Fax: 770-538-3862 |