Doctor Name: | MRS. DEIDRE D. KIEFER |
NPI Number: | 1588743017 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S./CCC/SLP/L |
License Number: | 004395 |
Business Practice Address: | 2386 Clower St Build. E, Suite 102 Snellville, GA - 300786134 |
Business Phone Number: | 7709859050 |
Business Fax Number: | 7709859223 |
Mailing Address: | 4142 Menlo Dr, TUCKER |
State: | GA |
Postal Code: | 300842225 |
Phone Number: | 7709398547 |
Fax Number: | 7709398769 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 004395 |
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 |