Individual
MRS. JILL NICOLE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
1400 NE MAIN ST, BETHANY ALF, VIDALIA, GA 30474
(912) 375-3797
Mailing address
PO BOX 53, ALAMO, GA 30411-0053
(912) 523-5683
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4920
GA
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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