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Individual

MISS REBECCA GOLDEN WALDROP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED, CCC-SLP

Contact information

Practice address
117 3RD ST E, TIFTON, GA 31794
(478) 455-1171
(229) 329-4532
Mailing address
PO BOX 7662, TIFTON, GA 31793-7662
(478) 455-1171

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008926
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14058959
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
Enumeration date
11/17/2015
Last updated
05/18/2018
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