Individual
MS. IDA RACHERYL LENOIR-MONROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDS,CCC,SLP
Contact information
Practice address
1505 AUGHTON CT, CONYERS, GA 30013-7410
(770) 679-0909
Mailing address
1505 AUGHTON CT, CONYERS, GA 30013-7410
(770) 679-0909
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3007
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05378356
—
MS
Enumeration date
10/31/2005
Last updated
03/28/2012
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