Individual
MS. SUSAN E. WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP
Contact information
Practice address
3624 OLD PETERSBURG RD, MARTINEZ, GA 30907-2865
(706) 364-4370
Mailing address
3624 OLD PETERSBURG RD, MARTINEZ, GA 30907-2865
(706) 364-4370
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1031
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SLP001031
—
GA
Enumeration date
04/01/2009
Last updated
04/01/2009
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