Individual
BONNIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1011 JACOB DR, WATKINSVILLE, GA 30677-7020
(706) 201-6944
Mailing address
1011 JACOB DR, WATKINSVILLE, GA 30677-7020
(706) 201-6944
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007420
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP007420
STATE LICENSE
GA
Enumeration date
09/08/2010
Last updated
09/08/2010
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