Individual
JESSICA MARIE STANDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
3105 CREEKSIDE VILLAGE DR. SUITE 604, KENNESAW, GA 30144
(770) 974-2424
(866) 384-6451
Mailing address
604 GOLF CREST DRIVE, SUITE 275, ACWORTH, GA 30101-4530
(678) 373-9705
(866) 384-6451
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007204
GA
Other
Enumeration date
09/13/2010
Last updated
06/11/2020
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