Individual
MADISAN MAE HERSLEBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
273 QUILLIAN STREET, CLEVELAND, GA 30528
(706) 865-6800
Mailing address
125 WIND FOREST CT, CLARKESVILLE, GA 30523
(770) 823-0954
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP013246
GA
Other
Enumeration date
01/11/2019
Last updated
10/09/2024
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