Individual
GWENDOLYN M WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8050 STILLMIST DR, FAIRBURN, GA 30213-7430
(910) 200-4840
Mailing address
8050 STILLMIST DR, FAIRBURN, GA 30213-7430
(910) 200-4840
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2889
NC
235Z00000X
Speech-Language Pathologist
Primary
SLP008494
GA
314000000X
Skilled Nursing Facility
2889
NC
Other
Enumeration date
05/20/2008
Last updated
06/25/2021
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