Healthcare Provider Details

I. General information

NPI: 1629145255
Provider Name (Legal Business Name): LASKIN THERAPY GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W JACKSON ST STE 2
RIDGELAND MS
39157-2355
US

IV. Provider business mailing address

207 W JACKSON ST STE 2
RIDGELAND MS
39157-2355
US

V. Phone/Fax

Practice location:
  • Phone: 601-362-0859
  • Fax: 601-362-0870
Mailing address:
  • Phone: 601-212-0870
  • Fax: 601-362-0870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMS
# 4
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateMS

VIII. Authorized Official

Name: REBECCA D. LASKIN
Title or Position: PRESIDENT
Credential: M.C.D., C.C.C., SLP
Phone: 601-212-0870