Individual
MISS ANGELA TENNILLE MYRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
405 PHILIP BLVD APT 914, LAWRENCEVILLE, GA 30046-8758
(770) 841-2918
Mailing address
545 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3389
(678) 377-2833
(678) 377-2882
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008109
GA
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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