JILL WIDEM

JOHNS CREEK, GA
NPI1083167993
Former NameJILL KATHERINE AMUNDSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: GA  SLP007721)
Enumeration Date2016-07-27
Last Update Date2016-07-27
Business Address
-- JILL WIDEM
775 ELLSBOROUGH CT
JOHNS CREEK, GA 30005-2575
Phone number: 404-518-0944
Mailing Address
-- JILL WIDEM
775 ELLSBOROUGH CT
JOHNS CREEK, GA 30005-2575
Phone number: 404-518-0944
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