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Individual

MS. MARY GRACE HOBBY I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
177 HOBBY LN, ASHBURN, GA 31714-1926
(229) 567-2781
Mailing address
177 HOBBY LN, ASHBURN, GA 31714-1926
(229) 567-2781

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004887
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
197996
BLUE SHIELD
GA
01
46478BA1
WELLCARE
GA
01
52197809001
EDI ENS
GA
Enumeration date
11/20/2006
Last updated
07/08/2007
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