Individual
MRS. MARY ANN WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3354 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 244-3552
(229) 244-7030
Mailing address
3354 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 244-3552
(229) 244-7030
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009908
GA
Other
Enumeration date
11/22/2017
Last updated
05/25/2022
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