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Individual

KELLY LEIGH VITUG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
3490 JOE CHANDLER RD, GAINESVILLE, GA 30507-7748
(770) 540-7253
Mailing address
3490 JOE CHANDLER ROAD, GAINESVILLE, GA 30507
(770) 540-7253

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007702
GA

Other

Enumeration date
09/14/2012
Last updated
09/14/2012
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