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General NPI Number Information
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NPI Number | 1255023057
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Entity Type | Individual
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Provider Name | KELSEY RONESIA RANSOM
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 207 W JACKSON ST STE 2
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City | RIDGELAND
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State | MS
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Zip | 39157-2355
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Country | US
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Telephone | 601-362-0859
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Fax | 601-362-0870
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Provider Business Mailing Address
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Address Line | 619 SAINT CHARLES ST
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City | FLORA
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State | MS
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Zip | 39071-9758
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Country | US
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Telephone | 601-506-2684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | S-5047
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License Number State | MS
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