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MARIANNE ALTARES
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1164908885
Individual Registrant: MARIANNE ALTARES
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1709 OAKBROOK LAKE DR NORCROSS, GA 30093 US
Tel: 706-248-5203 Fax: --
Tel: 706-248-5203 Fax: --
Contact information for business:
1709 OAKBROOK LAKE DR NORCROSS, GA 30093-1756 US
Tel: 706-248-5203 Fax: --
Tel: 706-248-5203 Fax: --
Registration Information:
NPI: 1164908885
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | GA | 1392961 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION | 14087752 | 01 | |
| GEORGIA PROFESSIONAL STANDARDS COMMISSION | 1392961 | GA | 01 |
