Individual
KATITLYN BUSKIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.SP.
Contact information
Practice address
170 RUMSON RD, ATHENS, GA 30605-3926
(610) 428-6332
(866) 753-4652
Mailing address
170 RUMSON RD, ATHENS, GA 30605-3926
(610) 428-6332
(866) 753-4652
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007652
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP007652
STATE LICENSE
GA
Enumeration date
09/13/2011
Last updated
09/13/2011
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