Individual
MISS KELLY NICOLE GIDDENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED CCC SLP
Contact information
Practice address
6220 GROVE ST, LULA, GA 30554-2942
(770) 653-1707
Mailing address
6220 GROVE ST, LULA, GA 30554-2942
(770) 653-1707
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1373774
GA
Other
Enumeration date
02/12/2019
Last updated
04/30/2025
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