Doctor Name: | MRS. SAMANTHA FORDHAM DEPUE |
NPI Number: | 1114041613 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. CCC-SLP |
License Number: | SLP6138 |
Business Practice Address: | 6298 Veterans Pkwy Suite 5a Columbus, GA - 319096258 |
Business Phone Number: | 7063227762 |
Business Fax Number: | 7066608316 |
Mailing Address: | 690 Laurel Ridge Ln, CATAULA |
State: | GA |
Postal Code: | 318042869 |
Phone Number: | 7066601995 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 08/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP6138 |
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 |