Individual
KEANNA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
175 BRADFORD SQ STE A, FAYETTEVILLE, GA 30215
(678) 438-7168
(470) 377-8097
Mailing address
210 MCINTOSH PLACE DR, FAYETTEVILLE, GA 30214-7384
(678) 485-1470
(470) 377-8097
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006202
GA
Other
Enumeration date
11/01/2005
Last updated
05/16/2025
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