Individual
MS. EBONY L. JASPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1432 PENHURST DR, LAWRENCEVILLE, GA 30043-8165
(678) 830-6632
(678) 830-6632
Mailing address
1432 PENHURST DR, LAWRENCEVILLE, GA 30043-8165
(678) 830-6632
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004108
GA
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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