Doctor Name: | MRS. MARTHA CHRISTINE CANNON-MEDCALF |
NPI Number: | 1275606014 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED, CCC |
License Number: | SLP003411 |
Business Practice Address: | 3483 Satellite Blvd Suite 304 Duluth, GA - 300968692 |
Business Phone Number: | 7704181778 |
Business Fax Number: | |
Mailing Address: | 2800 Manor Brook Ct, SNELLVILLE |
State: | GA |
Postal Code: | 300783062 |
Phone Number: | 7704181778 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP003411 |
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 |