Individual
AMANDA DEROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
470 S HILL ST, BUFORD, GA 30518-3220
(678) 482-6100
(770) 932-5684
Mailing address
470 S HILL ST, BUFORD, GA 30518-3220
(678) 482-6100
(770) 932-5684
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004505
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP004505
SPEECH THERAPY LICENSE
GA
Enumeration date
05/04/2007
Last updated
05/12/2015
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