Individual
MRS. MARY GRACE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4116 ARKWRIGHT RD, SUITE 2, MACON, GA 31210-1707
(478) 477-0601
(973) 965-4580
Mailing address
4116 ARKWRIGHT RD, SUITE 2, MACON, GA 31210-1707
(478) 477-0601
(973) 965-4580
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007411
GA
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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