Individual
ROBERTA KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP-CCC-SLP
Contact information
Practice address
2315 CENTRAL AVE STE C, AUGUSTA, GA 30904-6246
(706) 364-6172
Mailing address
579 BAY HL, MARTINEZ, GA 30907-8993
(706) 869-8402
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006465
GA
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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