Individual
JENNIFER L RAULERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2019 ALICE ST, SUITE B, WAYCROSS, GA 31501-6209
(706) 614-2248
(706) 353-1606
Mailing address
PO BOX 673, PATTERSON, GA 31557-0673
(706) 614-2248
(706) 353-1606
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005585
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10080845
AMERIGROUP COMMUNITY CARE
GA
01
—
344381
WELLCARE HEALTH - GA REGION
GA
01
—
52058554002
BCBS OF GA
GA
05
—
833369342A
—
GA
Enumeration date
05/14/2008
Last updated
02/06/2017
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