Individual
MARY CATHERINE LANIER TINTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED. CCC-SLP
Contact information
Practice address
1192 FOSTER ST NW, ATLANTA, GA 30318-4329
(404) 337-7436
Mailing address
1192 FOSTER ST NW, ATLANTA, GA 30318-4329
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11211
NC
235Z00000X
Speech-Language Pathologist
SLP 006442
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
907617108A
—
GA
Enumeration date
10/02/2006
Last updated
05/01/2015
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