| Doctor Name: | MRS. DARLA WIGGINS HARTZOG |
| NPI Number: | 1003972704 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MCD, CCC-SLP |
| License Number: | SLP005874 |
| Business Practice Address: | 106 Mcdonald Ave Cuthbert, GA - 398405828 |
| Business Phone Number: | 2292091293 |
| Business Fax Number: | 2297326976 |
| Mailing Address: | 361 Randolph St, CUTHBERT |
| State: | GA |
| Postal Code: | 398406127 |
| Phone Number: | 2292091293 |
| Fax Number: | 2297326976 |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 06/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP005874 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |