Doctor Name: | RALPH SMITH DELOACH |
NPI Number: | 1730255035 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED.,CCC-SLP |
License Number: | SLP004677 |
Business Practice Address: | 3615 Braselton Hwy Suite 103 Dacula, GA - 300195906 |
Business Phone Number: | 6783779634 |
Business Fax Number: | 6783779609 |
Mailing Address: | 3615 Braselton Hwy, Suite 103 DACULA |
State: | GA |
Postal Code: | 300195906 |
Phone Number: | 6783779634 |
Fax Number: | 6783779609 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP004677 |
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 |