| Chyan A Black, | |
|
3615 Braselton Hwy Ste 103, Dacula, GA 30019-5907 | |
| (678) 377-9634 | |
| (678) 377-9609 |
| Full Name | Chyan A Black |
|---|---|
| Gender | Female |
| Speciality | Qualified Speech Language Pathologist |
| Experience | 2 Years |
| Location | 3615 Braselton Hwy Ste 103, Dacula, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396569687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | PCET004159 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Empowerme Rehabilitation Illinois Llc | 2365718277 | 361 |
| Provider Name | Empowerme Rehabilitation Illinois LLC |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1679098263 PECOS PAC ID: 2365718277 Enrollment ID: O20171020001353 |
| Provider Name | Empowerme Wellness Kansas City LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1174118103 PECOS PAC ID: 9830504836 Enrollment ID: O20210317001954 |
| Mailing Address | Practice Location Address |
|---|---|
| Chyan A Black, 3615 Braselton Hwy Ste 103, Dacula, GA 30019-5907 Ph: (678) 377-9634 | Chyan A Black, 3615 Braselton Hwy Ste 103, Dacula, GA 30019-5907 Ph: (678) 377-9634 |
Beatrice Szabo Taylor, MA, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3581 Braselton Hwy, Dacula, GA 30019 Phone: 770-293-7864 |
Lucy L Dexter, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3615 Braselton Hwy Ste 103, Dacula, GA 30019 Phone: 678-377-9634 Fax: 678-377-9609 |
Heidi Lawson Clayton, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3615 Braselton Hwy Ste 103, Dacula, GA 30019 Phone: 678-377-9634 Fax: 678-377-9609 |
Katherine S. Gentzel, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3615 Braselton Hwy Ste 103, Dacula, GA 30019 Phone: 678-377-9634 Fax: 678-377-9609 |
Asiah Lavonne Wilborn, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1691 Cobblefield Cir, Dacula, GA 30019 Phone: 678-349-6151 |
Lauren Cochran, MED, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1854 Auburn Rd Ste 101, Dacula, GA 30019 Phone: 770-904-6009 |
Adelyn Joy Simmons, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3615 Braselton Hwy Ste 103, Dacula, GA 30019 Phone: 678-377-9634 Fax: 678-377-9609 |