Individual
JENNA GRAVITT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4640 MARTIN RD, CUMMING, GA 30041-5571
(678) 679-1261
Mailing address
4640 MARTIN RD, CUMMING, GA 30041-5542
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009680
GA
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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