Individual
MIRANDA STUTESMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
135 KYLEE CT, VILLA RICA, GA 30180-4407
(770) 846-8041
Mailing address
135 KYLEE CT, VILLA RICA, GA 30180-4407
(770) 846-8041
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009976
GA
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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