Individual
SHELBY LOUISE FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 W VINCENT DR, ATHENS, GA 30607-6547
(706) 389-2954
Mailing address
4879 TARRY GLEN DR, SUWANEE, GA 30024-7565
(770) 601-3262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009856
GA
Other
Enumeration date
12/27/2016
Last updated
08/14/2019
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