Individual
JILL M DECORSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4280 HICKORY FLAT HWY, STE 108, CANTON, GA 30115
(770) 345-2804
Mailing address
4280 HICKORY FLAT HWY, STE 108, CANTON, GA 30115
(770) 345-2804
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001267
GA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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