Individual
JENNIFER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 HOWARD LN, FAYETTEVILLE, GA 30215-1849
(770) 460-0165
Mailing address
130 HOWARD LN, FAYETTEVILLE, GA 30215-1849
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004626
GA
Other
Enumeration date
02/20/2009
Last updated
02/20/2009
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