Organization
JLD SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAYLA S BULLOCK M.ED., CCC/SLP (OWNER/ SPEECH LANGUAGE PATHOLOGIST)
(912) 539-1612
Entity
Organization
Contact information
Practice address
618 BOWENS MILL RD SW, DOUGLAS, GA 31533-3926
(912) 539-1612
(912) 764-6494
Mailing address
PO BOX 3306, DOUGLAS, GA 31534-3306
(912) 539-1612
(912) 764-6494
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005166
GA
Other
Enumeration date
01/17/2010
Last updated
01/17/2010
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