| Doctor Name: | CONNIE SUE REARDON |
| NPI Number: | 1417075011 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | SLP007416 |
| Business Practice Address: | 4000 Village View Drive Gainesville, GA - 30506 |
| Business Phone Number: | 6784503030 |
| Business Fax Number: | |
| Mailing Address: | 2605 Matlin Way, BUFORD |
| State: | GA |
| Postal Code: | 30519 |
| Phone Number: | 3305926788 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 07/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP007416 |
| 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 |