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General NPI Number Information
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NPI Number | 1265851380
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Entity Type | Organization
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Legal Business Name | TOTS TO TEENS COMMUNICATION THERAPY, LLC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 117B N MAIN ST
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City | PICAYUNE
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State | MS
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Zip | 39466-3928
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Country | US
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Telephone | 601-889-9800
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Fax | 601-889-9885
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Provider Business Mailing Address
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Address Line | 117 B N. MAIN ST.
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City | PICAYUNE
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State | MS
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Zip | 39466
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Country | US
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Telephone | 601-889-9800
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Fax | 601-889-9885
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. STEPHANIE THERIOT
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Credential | M.S. CCC-SLP
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Telephone | 601-889-9800
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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 |
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License Number State |
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