Individual
BETH WELDON TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1071 THOMAS AVE, WATKINSVILLE, GA 30677-6073
(770) 207-6390
Mailing address
1071 THOMAS AVE, WATKINSVILLE, GA 30677-6073
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP001581
PROFESSIONAL LICENSE
GA
Enumeration date
07/01/2020
Last updated
07/01/2020
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