Individual
MARIEA BECKNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
3745 CHEROKEE ST NW STE 203, KENNESAW, GA 30144-6789
(404) 316-8796
(770) 529-8917
Mailing address
2914 ALBRIGHT COMMONS NW, KENNESAW, GA 30144-2326
(770) 529-7068
(404) 316-8796
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005512
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
548772512B
—
GA
Enumeration date
02/06/2007
Last updated
08/02/2024
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