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Organization

CHEERIE GENTRY HUDSON, MED CCC-SLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHEERIE GENTRY HUDSON MED CCC-SLP (OWNER/SPEECH & LANGUAGE PATHOLOGIST)
(229) 831-7555
Entity
Organization

Contact information

Practice address
128 BERRY LN, CHULA, GA 31733-3422
(229) 831-7555
Mailing address
128 BERRY LN, CHULA, GA 31733-3422
(229) 831-7555

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001947
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003158706A
GA
Enumeration date
04/28/2015
Last updated
04/28/2015
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