Individual
DIANNA L MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1175 OGLETHORPE AVE STE B, ATHENS, GA 30606-2129
(706) 372-4349
Mailing address
170 CARPENTERS CIR, ATHENS, GA 30601-3102
(346) 324-8588
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870796487A
—
GA
Enumeration date
07/31/2006
Last updated
12/13/2024
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