Doctor Name: | DANIELLE MCGOWAN |
NPI Number: | 1043570054 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PCET001666 |
Business Practice Address: | 3760 Lavista Rd Suite 102 Tucker, GA - 300845615 |
Business Phone Number: | 4042480415 |
Business Fax Number: | 4042480422 |
Mailing Address: | 3760 Lavista Rd, Suite 102 TUCKER |
State: | GA |
Postal Code: | 300845615 |
Phone Number: | 4042480415 |
Fax Number: | 4042480422 |
NPI Enumeration Date: | 05/23/2012 |
NPI Last Update Date: | 05/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | PCET001666 |
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 |