Individual
SYDNEY VIRGINIA PONCE DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
495 WINN WAY STE 210, DECATUR, GA 30030-1710
(770) 209-9826
Mailing address
495 WINN WAY STE 210, DECATUR, GA 30030-1710
(770) 209-9826
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
PCET002877
GA
235Z00000X
Speech-Language Pathologist
Primary
SLP011023
GA
Other
Enumeration date
06/14/2019
Last updated
12/14/2022
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