Provider Demographics
NPI:1013275684
Name:CONNERS, MARJORY A (EDS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARJORY
Middle Name:A
Last Name:CONNERS
Suffix:
Gender:F
Credentials:EDS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-2442
Mailing Address - Country:US
Mailing Address - Phone:912-354-8160
Mailing Address - Fax:
Practice Address - Street 1:702 E 46TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-2442
Practice Address - Country:US
Practice Address - Phone:912-354-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP001730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist