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Individual

CHANDA C BOURGEOIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MED, CCC, SLP

Contact information

Practice address
26 BRADLEY LN, CLEVELAND, GA 30528-3800
(706) 892-8938
Mailing address
26 BRADLEY LN, CLEVELAND, GA 30528-3800
(706) 892-8938

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003746
GA

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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