Individual
LAURA MULLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.CCC-SLP
Contact information
Practice address
2941 N ASHLEY ST, SUITE D, VALDOSTA, GA 31602-5945
(229) 253-8500
(229) 253-8522
Mailing address
2941 N ASHLEY ST, SUITE D, VALDOSTA, GA 31602-5945
(229) 253-8500
(229) 253-8522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006355
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP006355
GEORGIA SECRETARY OF STATE
GA
Enumeration date
11/28/2016
Last updated
11/28/2016
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