Individual
KAREN DETLEFSEN PRICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
200 IVY CREEK DR, LOGANVILLE, GA 30052-3119
(404) 883-6913
(770) 554-0156
Mailing address
200 IVY CREEK DR, LOGANVILLE, GA 30052-3119
(404) 883-6913
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004265
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000785793B
—
GA
Enumeration date
08/24/2005
Last updated
10/26/2022
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