Individual
MRS. AMY ALICIA AGUAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.,CCC-SLP
Contact information
Practice address
6035 PEACHTREE RD STE C120, DORAVILLE, GA 30360-3234
(678) 514-3270
Mailing address
6035 PEACHTREE RD STE C120, DORAVILLE, GA 30360-3234
(678) 514-3270
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008350
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003139764A
—
GA
Enumeration date
10/21/2013
Last updated
12/13/2021
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