Individual
LACEY KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2280 US 29, NEWNAN, GA 30265
(770) 683-6833
Mailing address
2280 US 29, NEWNAN, GA 30265
(678) 588-8687
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009612
GA
Other
Enumeration date
11/13/2020
Last updated
11/19/2020
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