Individual
MISS SHIESHA RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 SPRING ST SE STE 108, GAINESVILLE, GA 30501-3773
(770) 615-7676
Mailing address
317 PRESTWICK DR, HOSCHTON, GA 30548-6811
(870) 270-1434
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
008870
GA
Other
Enumeration date
07/31/2011
Last updated
09/14/2022
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