Individual
DR. MARY L. DUNCAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLINSCD CCC-SLP
Contact information
Practice address
4549 REVENUE TRL, ELLENWOOD, GA 30294-6413
(404) 805-2875
(404) 738-2128
Mailing address
4549 REVENUE TRL, ELLENWOOD, GA 30294-6413
(404) 805-2875
(866) 925-7840
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.011397
IL
235Z00000X
Speech-Language Pathologist
2202009271
VA
235Z00000X
Speech-Language Pathologist
Primary
6225
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410111878A
—
GA
05
—
410111878F
—
GA
Enumeration date
12/27/2006
Last updated
06/10/2021
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