| NPI | 1679602841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY EVONT EVANS Speech Pathologist 770-492-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005335) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP 005885) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |