Provider Demographics
NPI:1043203508
Name:HESTER, GERI A (M ED CCC SLP)
Entity Type:Individual
Prefix:
First Name:GERI
Middle Name:A
Last Name:HESTER
Suffix:
Gender:F
Credentials:M ED CCC SLP
Other - Prefix:
Other - First Name:GERI
Other - Middle Name:A
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M ED CCC SLP
Mailing Address - Street 1:372 JP PERRY RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN PARK
Mailing Address - State:GA
Mailing Address - Zip Code:31771-4041
Mailing Address - Country:US
Mailing Address - Phone:229-769-3401
Mailing Address - Fax:229-769-3511
Practice Address - Street 1:372 JP PERRY RD
Practice Address - Street 2:
Practice Address - City:NORMAN PARK
Practice Address - State:GA
Practice Address - Zip Code:31771-4041
Practice Address - Country:US
Practice Address - Phone:229-769-3401
Practice Address - Fax:229-769-3511
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004096235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000811247BMedicaid
GASLP004096OtherGA LICENSE NO.
12014030OtherASHA ACCT NO.