| NPI | 1063743953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYLA S BULLOCK Owner/ Speech Language Pathologist 912-539-1612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 005166) |
| Enumeration Date | 2010-01-17 |
| Last Update Date | 2010-01-17 |