Individual
MS. NICOLE LATRELLE MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 N MAIN ST STE A1A, HINESVILLE, GA 31313-2533
(912) 320-4573
Mailing address
306 N MAIN ST STE A1A, HINESVILLE, GA 31313-2533
(912) 320-4573
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET002444
GA
Other
Enumeration date
09/25/2016
Last updated
09/25/2016
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