Individual
ROGER CLECKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1637 SAMANTHA PL SW, MARIETTA, GA 30008-8807
(678) 471-5734
Mailing address
1637 SAMANTHA PL SW, MARIETTA, GA 30008-8807
(678) 471-5734
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006191
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
664273564B
—
GA
Enumeration date
10/31/2006
Last updated
11/22/2011
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