Sally Grumbles

Individual provider Active NPI Speech-Language Pathologist · Sharpsburg, GA

NPI 1104186147 · NPPES record last updated May 24, 2012

Key facts

NPI
1104186147
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
382839 (GA)
Practice address
30 Bellview RDG
Sharpsburg, GA 30277-1556
Phone
(770) 463-3413
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
382839GAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 382839 GA Yes

Addresses

Primary practice location

30 Bellview RDG
Sharpsburg, GA 30277-1556

Mailing address

30 Bellview RDG
Sharpsburg, GA 30277-1556

Other providers in Sharpsburg, GA

All providers in Sharpsburg, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.