| NPI | 1467576140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON GLOVER Office Manager 706-324-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 062134) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: GA 062134) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-08-28 |