Individual
MARY JANUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
402 MAGNOLIA ST, ST SIMONS IS, GA 31522-1348
(912) 634-0887
Mailing address
402 MAGNOLIA ST, ST SIMONS IS, GA 31522-1348
(912) 634-0887
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP002066
GA
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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