| NPI | 1144624222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA MAYE DWIGHT Speech Language Pathologist 770-502-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP003372) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |