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General NPI Number Information
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NPI Number | 1194836056
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Entity Type | Organization
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Legal Business Name | THERAPY ZONE, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 7160 TCHULAHOMA BLD B, SUITE 4
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9266
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Country | US
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Telephone | 662-349-2733
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Fax | 662-536-1849
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Provider Business Mailing Address
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Address Line | 7160 TCHULAHOMA BLD B-SUITE 4
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9266
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Country | US
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Telephone | 662-349-2733
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Fax | 662-536-1849
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Authorized Official
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Title or Position | OWNER/ SPEECH LANG. PATHOLOGIST
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Name | MS. LESLIE J HAMMOND
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Credential | MS CCC SLP
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Telephone | 662-349-2733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | S2277
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License Number State | MS
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