Individual
TARA E FELIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2801 DEKALB MEDICAL PKWY, LITHONIA, GA 30058-4996
(404) 501-8570
Mailing address
3243 BONWAY DR, DECATUR, GA 30032-2429
(678) 592-5528
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP010040
GA
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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