Individual
MRS. DEIDRE D. KIEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S./CCC/SLP/L
Contact information
Practice address
2386 CLOWER ST, BUILD. E, SUITE 102, SNELLVILLE, GA 30078-6134
(770) 985-9050
(770) 985-9223
Mailing address
4142 MENLO DR, TUCKER, GA 30084-2225
(770) 939-8547
(770) 939-8769
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004395
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00816868A
—
GA
Enumeration date
11/03/2006
Last updated
07/08/2007
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