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Individual

OGECHI-ADA EBBIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-

Contact information

Practice address
6478 PUTNAM FORD DR, SUITE 116, WOODSTOCK, GA 30189-6984
(678) 494-8045
(678) 494-8047
Mailing address
6478 PUTNAM FORD DR, SUITE 116, WOODSTOCK, GA 30189-6984
(678) 494-8045
(678) 494-8047

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET001630
GA

Other

Enumeration date
04/13/2011
Last updated
04/13/2011
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