| NPI | 1417013665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE E JACKSON Owner 404-917-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: GA SLP001552) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |