Marcus Samuel Maddox, SLP
Speech-Language Pathologist, in Mableton, GA. Individual provider (NPI-1).
NPI number1083692552
StatusActive
Last updated in NPPESJan 30, 2024
Details
- NPI
- 1083692552
- Entity type
- Individual (NPI-1)
- Name
- Mr. Marcus Samuel Maddox
- Credential
- SLP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 5, 2006
- Certification date
- Jan 30, 2024
- Last updated
- Jan 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | SLP005885 | GA | Yes |
Practice location
5967 Cedar Ln SwMableton, GA 30126-3801
Phone 678-481-7209 · Fax 678-669-2325
Mailing address
5967 Cedar Ln SwMableton, GA 30126-3801
Phone 678-481-7209 · Fax 678-669-2325
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