Doctor Name: | RANDI GRANTHAM NGUYEN |
NPI Number: | 1568713121 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED SLP |
License Number: | SLP007853 |
Business Practice Address: | 1102 Smith Ave Ste C Thomasville, GA - 317925700 |
Business Phone Number: | 2292271433 |
Business Fax Number: | 2292266353 |
Mailing Address: | 1102 Smith Ave Ste C, THOMASVILLE |
State: | GA |
Postal Code: | 317925700 |
Phone Number: | 2292271433 |
Fax Number: | 2292266353 |
NPI Enumeration Date: | 09/24/2012 |
NPI Last Update Date: | 09/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP007853 |
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 |