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NPI 1558613463

NPI 1558613463 : COURTNEY FRANKLIN M.S., CCC-SLP : JACKSON, MS

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General NPI Number Information
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    NPI Number           |    1558613463
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    Entity Type          |    Individual 
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    Provider Name        |    COURTNEY FRANKLIN M.S., CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/03/2012
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    Last Update Date     |    07/08/2022
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Provider Practice Location Address
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    Address Line         |    6316 LYNDON B JOHNSON DR 
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    City                 |    JACKSON
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    State                |    MS
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    Zip                  |    39213-2921
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    Country              |    US
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    Telephone            |    601-850-8380
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    Fax                  |    769-447-0777
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Provider Business Mailing Address
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    Address Line         |    157 STRATFORD DR 
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    City                 |    MADISON
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    State                |    MS
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    Zip                  |    39110-7815
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    Country              |    US
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    Telephone            |    601-850-8380
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    Fax                  |    769-447-0777
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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       |    S3703
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    License Number State |    MS
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