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LACY BOUTWELL

Individual Provider (NPI-1) Active

Speech-Language Pathologist,

Provider Information

NPI Number
1164998928
Provider Type
Individual Provider (NPI-1)
Status
Active

Contact & Location

Address
524 S HOUSTON LAKE RD STE B300, WARNER ROBINS, GA, 310889042
Phone
(678) 910-3940
Fax
(404) 464-0819

Specialties & Taxonomies

Speech-Language Pathologist, Primary License: GA #SLP008941

All Addresses

MAILING

107 GRAND VIEW AVE

KATHLEEN, GA, 310472747

(678) 910-3940

LOCATION

524 S HOUSTON LAKE RD STE B300

WARNER ROBINS, GA, 310889042

(678) 910-3940