Doctor Name: | MS. IDA RACHERYL LENOIR-MONROE |
NPI Number: | 1568453595 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | EDS,CCC,SLP |
License Number: | S3007 |
Business Practice Address: | 1505 Aughton Ct Conyers, GA - 300137410 |
Business Phone Number: | 7706790909 |
Business Fax Number: | |
Mailing Address: | 1505 Aughton Ct, CONYERS |
State: | GA |
Postal Code: | 300137410 |
Phone Number: | 7706790909 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2005 |
NPI Last Update Date: | 03/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S3007 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
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 |