Aundra J Duncan, SLPD, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Port Wentworth, GA
NPI 1780190256 · NPPES record last updated Dec 13, 2024
Key facts
- NPI
- 1780190256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP009850 (GA)
- Practice address
- 2 Lake Shore Blvd
Port Wentworth, GA 31407-3610 - Phone
- (912) 417-6302
- NPI assigned
- Dec 20, 2017
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP009850 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | SLP009850 | GA | Yes |
Addresses
Primary practice location
2 Lake Shore Blvd
Port Wentworth, GA 31407-3610
Mailing address
105 Danielle Loop
Rincon, GA 31326-8115
Phone (478) 550-8876
Other providers in Port Wentworth, GA
- Angel Clark-Kennedy
- Amanda Clementz
- Latoya Sophia Cooper
- Dr Kenneith Durden Outreach
- Addie Elaine Duncan
- Kenneith Durden
- Effingham Hospital, Inc.
- Effingham Hospital, Inc.
- Elevate Applied Behavior Analysis Consulting LLC
- Exceptional Medical Services LLC
All providers in Port Wentworth, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.