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Organization
CHILDRENS THERAPY CENTER
Active
Organization
CHILDRENS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER RAULERSON CCC SLP (SEECH PATHOLOGIST)
(706) 353-3575
Entity
Organization
Contact information
Practice address
1500 OGLETHORPE AVE, SUITE 500 D, ATHENS, GA 30606-2179
(706) 353-3573
(706) 353-1606
Mailing address
1500 OGLETHORPE AVE, SUITE 500 D, ATHENS, GA 30606-2179
(706) 353-3573
(706) 353-1606
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005585
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
833369342A
—
GA
Enumeration date
12/19/2006
Last updated
08/22/2020
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