Individual
JENNIFER MASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3715 HARRISON RD STE 100, LOGANVILLE, GA 30052-8713
(678) 377-2833
(678) 502-7800
Mailing address
3650 ANGLIN RD, LOGANVILLE, GA 30052-6116
(678) 548-2098
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP012017
GA
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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