Individual
MRS. LINDA H RADCLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
101 DEVANT ST, SUITE 703, FAYETTEVILLE, GA 30214-2710
(770) 776-6013
(877) 469-5558
Mailing address
101 DEVANT ST, SUITE 703, FAYETTEVILLE, GA 30214-2710
(770) 776-6013
(877) 469-5558
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003812
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125104B
—
GA
01
—
202G155590
MEDICARE
GA
Enumeration date
06/22/2011
Last updated
06/04/2014
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