Individual
BIBIAN CAROL WISDOM -JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
255 RACETRACK RD, SUITE 12, MCDONOUGH, GA 30252-6834
(404) 663-1867
(404) 663-0774
Mailing address
PO BOX 2155, MCDONOUGH, GA 30253-1730
(404) 663-1867
(404) 663-0774
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001995
GA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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