Individual
MRS. ANSLEY MYRICK THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1737 GRAND OAKS DR, WOODSTOCK, GA 30188-4863
(404) 402-2579
Mailing address
1737 GRAND OAKS DR, WOODSTOCK, GA 30188-4863
(404) 402-2579
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007540
GA
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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