Provider Demographics
NPI:1740479575
Name:ANDERSON, GINGER (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 CURTIS PARKWAY NE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-1404
Mailing Address - Country:US
Mailing Address - Phone:706-529-3025
Mailing Address - Fax:706-383-6578
Practice Address - Street 1:215 CURTIS PARKWAY NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-1404
Practice Address - Country:US
Practice Address - Phone:706-529-3025
Practice Address - Fax:706-383-6578
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006733235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52222802001OtherBLUE CROSS BLUE SHIELD
GA422544OtherWELLCARE
GA342165589AMedicaid
GA01146328OtherAMERIGROUP