MRS. Stacey Lyn Gothard, MED CCC-SLP
NPI #1023165479 in Social Circle, Georgia
Provider Information
- NPI Number
- 1023165479
- Entity Type
- Individual
- Name
- MRS. Stacey Lyn Gothard, MED CCC-SLP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Speech-Language Pathologist
- Credential
- MED CCC-SLP
- Enumeration Date
- Jan 5, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 335 NICKLAUS CIR
- City
- Social Circle
- State
- Georgia
- ZIP Code
- 30025-5344
- Phone
- (678) 625-4556
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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