Individual
CAROLINE LANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3777 PEACHTREE RD NE APT 1524, BROOKHAVEN, GA 30319-3399
(770) 314-6215
Mailing address
3777 PEACHTREE RD NE APT 1524, BROOKHAVEN, GA 30319-3399
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005349
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP005349
STATE LICENSE
GA
Enumeration date
11/07/2015
Last updated
11/07/2015
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