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Individual

BROOKE CHESNUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. CF-SLP

Contact information

Practice address
3105 CREEKSIDE VILLAGE DR NW STE 602-604, KENNESAW, GA 30144-2394
(770) 974-2424
Mailing address
3105 CREEKSIDE VILLAGE DR NW STE 603604, KENNESAW, GA 30144-2394
(770) 974-2424

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET002798
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PCET002798
GEORGIA STATE LICENSURE
GA
Enumeration date
01/21/2019
Last updated
01/21/2019
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