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Contact Information

JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER
407 HARDSCRABBLE RD
ROSWELL, GA30075-1417
 Phone: 770-998-1017
 Fax: 770-998-3258
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
 

Pediatrics

2251P0200X 65 Physical Therapist in Private Practice
 

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
 

School

103TS0200X 62 Psychologist, Clinical
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for JACOBS LADDER NEURODEVELOPMENTAL LEARNING CENTER · (Female)

NPI Number 1871818641
Status Active
Credentials
Entity Individual
Enumeration date 04/05/2010
Last updated 11/23/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 09634048
  • GA License # 1059
  • GA License # LPC004163
  • GA License # MSW006790
  • GA License # MSW006914
  • GA License # OT005584
  • GA License # PT002001
  • GA License # PT010499
  • GA License # SLP007882
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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