Individual
MRS. MARILYN CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
102 PONDEROSA LN, WALESKA, GA 30183-4322
(770) 213-4040
Mailing address
102 PONDEROSA LN, WALESKA, GA 30183-4322
(770) 213-4040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4521
GA
Other
Enumeration date
06/16/2007
Last updated
07/02/2013
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