Individual
KELLY TASSITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
4319 S LEE ST STE 300, BUFORD, GA 30518-5752
(678) 288-9770
Mailing address
4319 S LEE ST STE 300, BUFORD, GA 30518-5752
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP010769
GA
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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