Individual
DANIEL DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
311 COOPER RD, LOGANVILLE, GA 30052-4976
(678) 205-5437
Mailing address
2340 MATLIN WAY, BUFORD, GA 30519-7191
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009349
GA
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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