Mary W Houston, SLP

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

NPI 1275844490 · NPPES record last updated Aug 12, 2016

Key facts

NPI
1275844490
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP003776 (GA)
Practice address
807 S Isabella St
Sylvester, GA 31791-7554
Phone
(229) 776-6961
NPI assigned
Jun 23, 2010
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
SLP003776GAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP003776 GA Yes

Addresses

Primary practice location

807 S Isabella St
Sylvester, GA 31791-7554

Mailing address

605 N Westberry St
Sylvester, GA 31791-1741
Phone (229) 347-4729

Other providers in Sylvester, GA

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

Sources for this page

Verify at the official NPI Registry.