| |
6689 Lake Park Rd, Lake Park, GA 31636-4505 | |
(910) 260-0969 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Speech-language Pathologist |
Location | 6689 Lake Park Rd, Lake Park, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518711175 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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6689 Lake Park Rd, Lake Park, GA 31636-4505 Ph: (910) 260-0969 | 6689 Lake Park Rd, Lake Park, GA 31636-4505 Ph: (910) 260-0969 |
Mrs. Kelly Green Jackson, S.L.P. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 5314 Moss Oak Trl, Lake Park, GA 31636 Phone: 386-362-8564 | |
Nancy Heath, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 5701 Clydetta Dr, Lake Park, GA 31636 Phone: 478-278-6900 |