Individual
ANGELINA BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 N PATTERSON ST, VALDOSTA, GA 31602-2940
(229) 244-4545
Mailing address
1701 N PATTERSON ST, VALDOSTA, GA 31602-2940
(229) 244-4545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
001219
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174741037
MTW ORGANIZATION NPI
GA
Enumeration date
07/31/2007
Last updated
07/31/2007
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