Organization
IMMACULATE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA DENISE WILLIAMS MA, CCC-SLP (SPEECH PATHOLOGIST)
(843) 461-7050
Entity
Organization
Contact information
Practice address
1143 FAULKNER WAY, JONESBORO, GA 30238-8075
(843) 461-7050
Mailing address
1143 FAULKNER WAY, JONESBORO, GA 30238-8075
(843) 461-7050
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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