Provider Demographics
NPI:1184962417
Name:FRANCE, GINA JAYNELLE (MA/CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GINA
Middle Name:JAYNELLE
Last Name:FRANCE
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2852 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6727
Mailing Address - Country:US
Mailing Address - Phone:678-863-7420
Mailing Address - Fax:
Practice Address - Street 1:210 COLLINS INDUSTRIAL WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5450
Practice Address - Country:US
Practice Address - Phone:678-442-0777
Practice Address - Fax:678-376-4320
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist