Individual
DEBRA BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30329
(404) 712-7288
(404) 712-7774
Mailing address
1444 LACHONA CT NE, ATLANTA, GA 30329-3411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1167
GA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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