Provider Demographics
NPI:1205947405
Name:WAUCHOPE, VICKI ROGERS (MED, CCC/A)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:ROGERS
Last Name:WAUCHOPE
Suffix:
Gender:F
Credentials:MED, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SCATTERFOOT DR
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1853
Mailing Address - Country:US
Mailing Address - Phone:619-200-4258
Mailing Address - Fax:
Practice Address - Street 1:1265 HIGHWAY 54 W
Practice Address - Street 2:STE 200
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4548
Practice Address - Country:US
Practice Address - Phone:404-785-4768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD0000003372231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist