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Individual

MRS. JAMEELA FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
3645 MARKETPLACE BLVD, SUITE 130-184, EAST POINT, GA 30344-5747
(770) 892-4878
(770) 892-4958
Mailing address
3645 MARKETPLACE BLVD, SUITE 130-184, EAST POINT, GA 30344-5747
(404) 245-4848
(770) 892-4958

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005380
GA
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000970153A
GA
Enumeration date
12/26/2006
Last updated
10/09/2020
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