Individual
ASHIA N FAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
4500 SATELLITE BLVD, DULUTH, GA 30096-5037
(678) 993-5122
Mailing address
4500 SATELLITE BLVD, DULUTH, GA 30096-5037
(678) 993-5122
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET001384
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCET001384
STATE LICENSE
GA
Enumeration date
11/07/2008
Last updated
08/24/2011
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