Individual
KYLEIGH GRACE DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED. CCC-SLP
Contact information
Practice address
311 COOPER RD, LOGANVILLE, GA 30052-4976
(678) 205-5437
Mailing address
5516 ROCKFERN DR, LILBURN, GA 30047-3867
(229) 305-7773
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP012656
GA
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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