Doctor Name: | CYNTHIA S GREEN |
NPI Number: | 1093160335 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SLP001281 |
Business Practice Address: | 1015 Pebble Creek Trl Suwanee, GA - 300241176 |
Business Phone Number: | 6784290313 |
Business Fax Number: | |
Mailing Address: | 1015 Pebble Creek Trl, SUWANEE |
State: | GA |
Postal Code: | 300241176 |
Phone Number: | 6784290313 |
Fax Number: | |
NPI Enumeration Date: | 04/24/2016 |
NPI Last Update Date: | 04/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP001281 |
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 |