Individual
KIMBERLY ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
631 SUMMERWIND DR, MACON, GA 31210-1547
(478) 477-5483
(478) 405-9400
Mailing address
631 SUMMERWIND DR, MACON, GA 31210-1547
(478) 477-5483
(478) 405-9400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005658
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
450232914A
—
GA
Enumeration date
12/18/2006
Last updated
07/09/2007
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