Individual
ALLISON J TKACZUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
522 E PONCE DE LEON AVE, DECATUR, GA 30030-1967
(410) 913-1174
Mailing address
522 E PONCE DE LEON AVE, DECATUR, GA 30030-1967
(410) 913-1174
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP010247
GA
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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