Individual
GRAYSON CATHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
226 FAIRVIEW RD, ELLENWOOD, GA 30294-2704
(800) 381-2195
Mailing address
2638 JODECO DR, JONESBORO, GA 30236-5312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011611
GA
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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