Individual
MS. ALICE MARY SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-A
Contact information
Practice address
110 CARLTON ST, ATHENS, GA 30602-5004
(706) 542-2371
(706) 542-4574
Mailing address
1071 SKIPSTONE CT, WATKINSVILLE, GA 30677-2269
(706) 769-3118
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1681
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00826141A
—
GA
Enumeration date
08/13/2006
Last updated
07/09/2007
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