Individual
MS. MICHELLE CAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
2581 OLD HICKORY DR NW, MARIETTA, GA 30064
(404) 790-0528
(877) 790-3285
Mailing address
2581 OLD HICKORY DR NW, MARIETTA, GA 30064
(404) 790-0528
(877) 790-3285
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003154237A
—
GA
05
—
003156166A
—
GA
Enumeration date
05/03/2011
Last updated
01/09/2020
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