Individual
KIM ROBERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
65 DARCEE CT, LAWRENCEVILLE, GA 30046-7402
(678) 858-4777
(678) 985-3953
Mailing address
3968 SAVANNAH RIDGE CT, LOGANVILLE, GA 30052-2582
(770) 972-5820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005978
GA
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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