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113 E Gaines St, Dublin, GA 31021-6157 | |
(478) 595-0317 | |
(888) 249-2172 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Multi-specialty |
Location | 113 E Gaines St, Dublin, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912429010 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | SLP005385 (Georgia) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Holly M Howard |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1356677272 PECOS PAC ID: 6204188824 Enrollment ID: I20181010000917 |
Mailing Address | Practice Location Address |
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2035 Rebie Rd, Dudley, GA 31022-2411 Ph: (478) 595-0317 | 113 E Gaines St, Dublin, GA 31021-6157 Ph: (478) 595-0317 |