Healthcare Provider Details

I. General information

NPI: 1821616277
Provider Name (Legal Business Name): LAGLEANIA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 05/21/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 STEED RD
RIDGELAND MS
39157-6982
US

IV. Provider business mailing address

5631 LEXY LN
SOUTHAVEN MS
38671-7029
US

V. Phone/Fax

Practice location:
  • Phone: 601-605-6777
  • Fax:
Mailing address:
  • Phone: 662-402-6512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: