Organization
GLOW FORWARD THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI REID LEAK (MS, CCC-SLP)
(252) 258-6200
Entity
Organization
Contact information
Practice address
1994 TOWNSHIP DR, WINDER, GA 30680-5633
(252) 258-6200
Mailing address
1994 TOWNSHIP DR, WINDER, GA 30680-5633
(252) 258-6200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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