Individual
RAVEN SAMONE WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2537 OAKLEAF RDG, LITHONIA, GA 30058-6638
(205) 499-5837
Mailing address
324 STEVENS ENTRY, PEACHTREE CITY, GA 30269-1325
(678) 619-0178
(678) 701-1139
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPA000313
GA
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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