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Organization

LEGACY THERAPY SOURCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CATHERINE GOMEZ CCC-SLP (OWNER)
(917) 848-1863
Entity
Organization

Contact information

Practice address
115 CHERRY HILL LN, STOCKBRIDGE, GA 30281-7360
(917) 848-1863
Mailing address
115 CHERRY HILL LN, STOCKBRIDGE, GA 30281-7360
(917) 848-1863

Taxonomy

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

Other

Enumeration date
08/24/2020
Last updated
08/24/2020
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