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Individual

PAULA L SUMPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S. CCC-SLP

Contact information

Practice address
1836 CONDOR DR NE, MARIETTA, GA 30066-1264
(404) 374-7956
(706) 553-8195
Mailing address
1836 CONDOR DR NE, MARIETTA, GA 30066-1264
(404) 374-7956
(770) 924-2116

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003429
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000806132D
GA
Enumeration date
07/03/2006
Last updated
10/05/2020
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