Individual
MRS. STACY IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED. CCC-SLP
Contact information
Practice address
212 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 345-7796
Mailing address
1450 YELLOW CREEK RD, BALL GROUND, GA 30107-3141
(770) 893-2699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004015
GA
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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