Individual
MS. CANITICE HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
6505 RIADA CT, MCDONOUGH, GA 30253-8535
(678) 422-6271
(678) 422-6696
Mailing address
PO BOX 1666, JONESBORO, GA 30237-1666
(678) 422-6271
(678) 422-6696
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005031
GA
Other
Enumeration date
01/02/2007
Last updated
07/09/2007
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