Organization
STACY BENNETT, SPEECH LANGUAGE PATHOLOGIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY BENNETT M.A.CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(678) 770-9362
Entity
Organization
Contact information
Practice address
2186 SMOKE STONE CIR, MARIETTA, GA 30062-6089
(770) 998-9359
Mailing address
2186 SMOKE STONE CIR, MARIETTA, GA 30062-6089
(770) 998-9359
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005003SLP
GA
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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