Individual
MS. NANCY BROADHURST DELLARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP
Contact information
Practice address
110 CARLTON ST, ATHENS, GA 30602-5004
(706) 542-4594
(706) 542-4574
Mailing address
116 RIVER BOTTOM CIR, ATHENS, GA 30606-1992
(706) 548-5773
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
000999
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000999
LICENSE
GA
Enumeration date
09/25/2006
Last updated
07/08/2007
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