Doctor Name: | MS. CHERISSE A FOWLES |
NPI Number: | 1700210101 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SLP 008253 |
Business Practice Address: | 652 Hope Hollow Ln Loganville, GA - 300526213 |
Business Phone Number: | 8667707294 |
Business Fax Number: | |
Mailing Address: | 2877 Deerwood Dr Sw, ATLANTA |
State: | GA |
Postal Code: | 303315506 |
Phone Number: | 6785227155 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2013 |
NPI Last Update Date: | 08/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP 008253 |
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 |