Individual
MRS. GRETCHEN WOODS POGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3985 ROLLING HILLS DR, CUMMING, GA 30041-9448
(404) 966-9496
Mailing address
5855 WILLOW OAK PASS, CUMMING, GA 30040-7506
(407) 415-3208
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SA8444
FL
235Z00000X
Speech-Language Pathologist
Primary
SLP008127
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000851900
—
FL
01
—
155583404
TRICARE
FL
05
—
891565200
—
FL
01
—
S9318
BCBS OF FLORIDA
FL
Enumeration date
11/29/2006
Last updated
11/27/2013
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