| Crucible Communication Therapy Llc | |
|
9765 Walnut Grove Trail, Villa Rica, GA 30180 | |
| (770) 727-2732 | |
| Not Available |
| Full Name | Crucible Communication Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 9765 Walnut Grove Trail, Villa Rica, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174161624 | NPI | - | NPPES |
| SLP010654 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Glenn Barnes |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164003141 PECOS PAC ID: 9234533225 Enrollment ID: I20210812003757 |
| Mailing Address | Practice Location Address |
|---|---|
| Crucible Communication Therapy Llc 9765 Walnut Grove Trail, Villa Rica, GA 30180 Ph: (770) 727-2732 | Crucible Communication Therapy Llc 9765 Walnut Grove Trail, Villa Rica, GA 30180 Ph: (770) 727-2732 |
Mary Kathryn Horsley, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 112 Three West Pkwy, Villa Rica, GA 30180 Phone: 770-459-6533 | |
Johanna Linnea Wagner, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 112 Three West Pkwy, Villa Rica, GA 30180 Phone: 770-459-6533 Fax: 770-462-1260 | |
Glenn Courtney Barnes, SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 9765 Walnut Grove Trl, Villa Rica, GA 30180 Phone: 770-570-2140 | |
Lynne Long, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 285 Blackstock Rd, Villa Rica, GA 30180 Phone: 770-855-1388 | |
Sarah Kate Godfrey, M. ED. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 112 Three West Pkwy, Villa Rica, GA 30180 Phone: 770-459-6533 | |
Brooke Cuff Burguillos, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1046 Monticello Dr, Villa Rica, GA 30180 Phone: 770-212-0750 |