Individual
GLENDA BERTHELOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1200 LAKE HEARN DR NE, SUITE 250, ATLANTA, GA 30319-1415
(404) 943-1007
(678) 802-7334
Mailing address
3558 PIEDMONT RD NE APT 1, ATLANTA, GA 30305-1563
(404) 421-2070
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0010070
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027299208
DRIVERS LICENSE
GA
Enumeration date
07/24/2012
Last updated
07/24/2012
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