Individual
MARYLYNN GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1244 CLAIRMONT RD, SUITE 224, DECATUR, GA 30030-1259
(404) 728-9766
(404) 728-9166
Mailing address
298 NELMS AVE NE, ATLANTA, GA 30307-2104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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