Individual
MARTHA MACKENZIE DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED, CCC-SLP
Contact information
Practice address
1305 PENNSYLVANIA AVE, MCDONOUGH, GA 30253-9116
(770) 584-9638
Mailing address
1016 EZEKIEL WAY, LOCUST GROVE, GA 30248-2196
(770) 584-9638
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
PCET001953
GA
235Z00000X
Speech-Language Pathologist
Primary
SLP008730
GA
Other
Enumeration date
08/28/2013
Last updated
07/21/2022
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