Individual
MARCIE BASILETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
756 NEESE RD, WOODSTOCK, GA 30188-4297
(404) 668-4877
Mailing address
756 NEESE RD, WOODSTOCK, GA 30188-4297
(404) 668-4877
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009397
GA
Other
Enumeration date
12/03/2016
Last updated
12/03/2016
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