Individual
LEAH REILLY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3044 DUE WEST ROAD, DALLAS, GA 30157-3015
(770) 443-9672
Mailing address
3044 DUE WEST RD, DALLAS, GA 30157-2125
(770) 443-9672
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP010245
GA
Other
Enumeration date
08/21/2018
Last updated
07/01/2019
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