Individual
CHARLENE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1381 GARNERS FRY, GREENSBORO, GA 30642-5176
(404) 667-0612
Mailing address
1381 GARNERS FRY, GREENSBORO, GA 30642-5176
(404) 667-0612
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01100201
ASHA MEMBER
GA
01
—
SLP001709
STATE OF GEORGIA LICENSE
GA
Enumeration date
04/07/2010
Last updated
04/07/2010
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