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Individual

KIMMERLY K HARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
4709 TUGALO TRL, DOUGLASVILLE, GA 30135-5879
(352) 282-1367
Mailing address
4709 TUGALO TRL, DOUGLASVILLE, GA 30135-5879
(352) 282-1367

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SA12108
FL
235Z00000X
Speech-Language Pathologist
Primary
SLP008206
GA

Other

Enumeration date
04/26/2012
Last updated
01/30/2017
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