Individual
MRS. NANCY WHITFORD LYFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED CCCSP
Contact information
Practice address
3932 KENDALL COVE, ATLANTA, GA 30340
(678) 793-1874
(678) 209-0602
Mailing address
3932 KENDALL COVE, ATLANTA, GA 30340
(678) 793-1874
(678) 209-0602
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP000830
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10057588
AMERIGROUP
GA
Enumeration date
04/17/2007
Last updated
07/08/2007
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