Raleigh, Victoria

Raleigh, Victoria is an individual health care provider with primary practice located at 1415 Alice St , Waycross GA 31501-4528. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Raleigh, Victoria can be contacted via phone (912) 283-0777.

Contact Information

Primary practice address
1415 Alice St Waycross GA 31501-4528
Phone: (912) 283-0777
Fax: (912) 283-7757
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005750 Georgia

Profile Details

NPI number 1972614121
LBN Legal business name Raleigh, Victoria
Credentials SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jun 16th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972614121 NPPES
Georgia MEDICAID 368163600D

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