Individual
TAWANDA FLUKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
148 WINDCROFT CT NW, ACWORTH, GA 30101-3783
(678) 732-5896
Mailing address
PO BOX 271, ACWORTH, GA 30101-0271
(678) 732-5896
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005839
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
383330152D
—
GA
Enumeration date
10/31/2006
Last updated
07/26/2010
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