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Individual

SUSAN LIGHTLE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
2526 PHEASANT DR, ALBANY, GA 31707-3021
(229) 439-8686
(229) 883-4484
Mailing address
2526 PHEASANT DR, ALBANY, GA 31707-3021
(229) 439-8686
(229) 883-4484

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001664
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00742321F
GA
Enumeration date
03/22/2006
Last updated
07/08/2007
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