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Individual

MRS. JERRI KAY HICKMAN TEMPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED. CCC-SLP

Contact information

Practice address
135 BROADWELL OAKS CT, ALPHARETTA, GA 30004-1589
(404) 964-4629
(770) 754-5998
Mailing address
135 BROADWELL OAKS CT, ALPHARETTA, GA 30004-1589
(404) 964-4629
(770) 754-5998

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003974
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000809839A
GA
Enumeration date
10/02/2013
Last updated
10/02/2013
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