Individual
STACEY MCGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1389 WEBER INDUSTRIAL DR, CUMMING, GA 30041-6468
(770) 886-6204
(678) 261-6421
Mailing address
1389 WEBER INDUSTRIAL DR, CUMMING, GA 30041-6468
(770) 886-6204
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCE002850
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCE002850
GEORGIA LICENSE
GA
Enumeration date
06/26/2019
Last updated
06/26/2019
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