Individual
SAMANTHA GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC SLP
Contact information
Practice address
1060 EUCLID AVE NE, ATLANTA, GA 30307-1954
(404) 242-0899
Mailing address
1060 EUCLID AVE NE, ATLANTA, GA 30307-1954
(404) 242-0899
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008100
GA
Other
Enumeration date
09/07/2013
Last updated
06/30/2014
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