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Individual

MRS. KATHERYN REAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
3801 SCHROER ROAD, VALDOSTA, GA 31605
(229) 244-3552
(229) 244-7030
Mailing address
3801 SCHROER ROAD, VALDOSTA, GA 31605
(229) 244-3552
(229) 244-7030

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005367
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
212833316B
GA
01
52171814
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/22/2007
Last updated
07/17/2013
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